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Sample records for vulva sparganosis misdiagnosed

  1. Vulva Anatomy

    MedlinePlus

    ... Pictures Browse Search Quick Search Image Details Vulva Anatomy View/Download: Small: 720x634 View Download Add to My Pictures Title: Vulva Anatomy Description: Anatomy of the vulva; drawing shows the ...

  2. Sparganosis in male breast.

    PubMed

    Tung, Cheng-Cheng; Lin, Jui-Wei; Chou, Fong-Fu

    2005-02-01

    Humans can acquire infection by sparganum or plerocercoid larva of the tapeworm from drinking water containing infected Cyclops species and by ingesting infected snakes, birds, or other mammals. Once infected, the plerocercoid larva migrate slowly in the tissues and present as a subcutaneous lesion, making the correct diagnosis difficult. A 38-year-old man visited our clinic due to a breast mass. Due to suspicion of gynecomastia or breast cancer, he underwent tumor excision. Unexpectedly, a long white worm was found in the breast tissue and the pathologic finding showed sparganosis. After the surgery, mebendazole was prescribed for 1 week. No recurrence of the sparganosis was found during 1-year follow-up. PMID:15765169

  3. Human sparganosis, a neglected food borne zoonosis.

    PubMed

    Liu, Quan; Li, Ming-Wei; Wang, Ze-Dong; Zhao, Guang-Hui; Zhu, Xing-Quan

    2015-10-01

    Human sparganosis is a food borne zoonosis caused by the plerocercoid larvae (spargana) of various diphyllobothroid tapeworms of the genus Spirometra. Human infections are acquired by ingesting the raw or undercooked meat of snakes or frogs, drinking untreated water, or using raw flesh in traditional poultices. More than 1600 cases of sparganosis have been documented worldwide, mostly in east and southeast Asia. Sporadic cases have been reported in South America, Europe, and Africa, and several cases have been described in travellers returning from endemic regions. Epidemiological data suggest that the increased effect of sparganosis on human health is because of greater consumption of raw meat of freshwater frogs and snakes. This Review provides information about the Spirometra parasites and their lifecycles, summarises clinical features, diagnosis, and treatment of human sparganosis, and describes geographical distribution and infection characteristics of Spirometra parasites in host animals. PMID:26364132

  4. Human ocular sparganosis in southern Brazil.

    PubMed

    Mentz, Márcia Bohrer; Procianoy, Fernando; Maestri, Marcelo Krieger; Rott, Marilise Brittes

    2011-01-01

    We report the first case of human ocular sparganosis in the state of Santa Catarina, southern Brazil. A young female patient presented with three periocular moveable inflammatory masses in her right eye, during two years. By surgical excisional biopsy, a helminth larval stage was removed and identified as sparganum. Clinical, laboratory and epidemiological data on this parasite are presented. PMID:21412620

  5. Intramuscular sparganosis in the gastrocnemius muscle: a case report.

    PubMed

    Kim, Jeung Il; Kim, Tae Wan; Hong, Sung Min; Moon, Tae Yong; Lee, In Sook; Choi, Kyung Un; Yu, Hak Sun

    2014-02-01

    Sparganosis is a parasitic infection caused by the plerocercoid tapeworm larva of the genus Spirometra. Although the destination of the larva is often a tissue or muscle in the chest, abdominal wall, extremities, eyes, brain, urinary tract, spinal canal, and scrotum, intramuscular sparganosis is uncommon and therefore is difficult to distinguish from a soft tissue tumor. We report a case of intramuscular sparganosis involving the gastrocnemius muscle in an elderly patient who was diagnosed using ultrasonography and MRI and treated by surgical excision. At approximately 1 cm near the schwannoma at the right distal sciatic nerve, several spargana worms were detected and removed. PMID:24623885

  6. Aggressive Angiomyxoma of the Vulva: A Précis for Primary Care Providers

    PubMed Central

    Elkattah, R.; Sarkodie, O.; Otteno, H.; Fletcher, A.

    2013-01-01

    Vulvar aggressive angiomyxoma (AA) is a rare mesenchymal tumor of the vulva. Due to its slow-growing nature, it is often overlooked and misdiagnosed by primary care providers (PCPs). We describe a case report of vulvar AA in a 38-year-old woman who underwent complete surgical excision of the neoplasm with no evidence of recurrence on a 5-year followup. A literature review follows to provide PCPs with the clinical, radiologic, and pathologic features that this tumor displays. PMID:24073346

  7. Giant fibroma of the vulva

    PubMed Central

    Abasiattai, Aniekan M; Umoiyoho, Aniefiok J; Umana, Ivy N; Utuk, Ntiense M

    2010-01-01

    A 50-year-old grandmultiparous petty trader presented in the gynaecological unit of the University of Uyo Teaching Hospital with a painless groin swelling of 8 years’ duration, which had progressively increased in size. She had received several concoctions from a traditional healer who also made several incisions on her thighs and inguinal region. On examination, there were multiple scarification marks in the axilla, inguinal region and medial aspects of both thighs. There was a very huge, firm, non-tender mass involving the right vulva and measuring 40 by 35 cm (figure 1). The vaginal orifice was deviated to the left by the mass, the uterus was normal size and the adnexa were normal. She had an excision biopsy under general anaesthesia (figure 2) and the histology confirmed fibroma of the vulva (figure 3). She had an uneventful postoperative period and the wound healed well with good cosmetic results. Figure 1A huge vulva mass. Figure 2The vulva after the mass has been excised. Figure 3The histology confirming fibroma of the vulva.

  8. Cerebral sparganosis in children: epidemiological, clinical and MR imaging characteristics

    PubMed Central

    2012-01-01

    Background Cerebral sparganosis in children is an extremely rare disease of central nervous system, and caused by a tapeworm larva from the genus of Spirometra. In this study, we discussed and summarized epidemiological, clinical and MR imaging characteristics of eighteen children with cerebral sparganosis for a better diagnosis and treatment of the disease. Methods Eighteen children with cerebral sparganosis verified by pathology, serological tests and MR presentations were retrospectively investigated, and the epidemiologic and clinical characteristics of the disease were studied. Results Twenty-seven lesions were found in the eighteen children. Twelve lesions in twelve patients were solitary while the lesions in the rest six patients were multiple and asymmetrical. The positions of the lesions were: seven in frontal, eleven in parietal, four in temporal and two in occipital lobes, one in basal ganglia, one in cerebella hemisphere and one in pons. The lesions were presented as slight hypointensity on T1-weighted images but moderate hyperintensity on T2-weighted images with perilesional brain parenchyma edema. Enhanced MR scans by using Gadopentetic Acid Dimeglumine Salt were performed in the patients, and the images demonstrated abnormal enhancements with the patterns of a peripheral ring, or a tortuous beaded, or a serpiginous tubular shape. Follow-up MR scans were preformed for eight patients, and three out of the eight cases exposed migrations and changes in shapes of the lesion areas. Conclusions The MR presentations in our study in general were similar to those in previous studies. However serpiginous tubular and comma-shaped enhancements of lesions have not been previously reported. The enhanced MR imaging and follow-up MR scans with the positive results from serological tests are the most important methods for the clinical diagnosis of cerebral sparganosis in children. PMID:23006504

  9. Cerebral sparganosis: case report and review of the European cases.

    PubMed

    Lo Presti, Anna; Aguirre, Daniel T; De Andrés, Pablo; Daoud, Lina; Fortes, José; Muñiz, Jesús

    2015-09-01

    Sparganosis is a severe parasitic infection caused by the larvae of Spirometra mansoni, also called "sparganum." In human hosts, the Spirometra mansoni larva commonly targets the subcutaneous tissue or muscle. Sometimes it can also migrate into the brain, resulting in cerebral sparganosis, mainly characterized by focal neurological symptoms such as seizures and radiological "wandering lesions" on magnetic resonance images (MRIs). Clinical cases of cerebral sparganosis have been reported worldwide, mainly in Asian countries, but also in North America, South America and Australia. Only two cases have been previously reported in Europe. A 29-year-old male from Bolivia, who lived in Spain, presented to our service for seizures and a multicystic brain lesion, initially suspected to be a dysembryoplastic neuroepithelial tumor (DNET). He underwent gross total resection of the mixed solid/cystic lesion. Pathology revealed gliosis, multiple interconnected cystic cavities with fibrous walls, inflammatory cell infiltration and no necrotizing granulomatous reaction. Inside the cavities, a parasitic form was identified as the larva of the cestode Spirometra mansoni. At 1-year follow-up, the patient had no deficits and was seizure free. Clinicians should be alerted to the possible existence of this rare entity in Europe, especially in patients from endemic areas with a possible infection history as well as "wandering lesions" on the MRI. PMID:26085111

  10. Carvenous lymphangioma of the vulva.

    PubMed

    Yoon, Kyung-Ran; Mo, A-Jin; Park, Sung-Ho; Na, Yeon Sik; Park, Sung Taek

    2015-01-01

    Lymphangioma is a rare proliferation of the lymphatic system which is classified as either lymphangioma circumscription or carvenous lymphangioma. The involvement of the vulva is very rare and only a small number of case reports have been made on carvenous lymphangioma of the vulva. We herein report a case of 20-year-old unmarried girl presented with gradually expanding and painless tumor of the left labium majus. The mass was removed surgically and pathology confirmed as carvenous lymphangioma, with no recurrences to date. PMID:25629024

  11. Apocrine adenocarcinoma of the vulva.

    PubMed

    Kajal, Babita; Talati, Hetal; Daya, Dean; Alowami, Salem

    2013-01-01

    Cutaneous vulvar carcinomas are predominantly of squamous cell carcinoma type. Primary vulvar adenocarcinomas are rare with a poorly understood histogenesis. They are classified into extramammary Paget's disease, sweat gland carcinomas, and breast-like adenocarcinomas of the vulva. Adenocarcinomas, originating from Bartholin glands, can also present as vulvar adenocarcinoma. Rare adenocarcinomas with apocrine features have been described in the literature. The origin of these neoplasms from the native apocrine sweat glands or from anogenital mammary-like glands is still debatable. We report herein a case of a 67 year old female with a rare primary apocrine carcinoma of the vulva. PMID:24179652

  12. Endoscopic resection of sparganosis presenting as colon submucosal tumor: A case report

    PubMed Central

    Kim, Joong Keun; Baek, Dong Hoon; Lee, Bong Eun; Kim, Gwang Ha; Song, Geun Am; Park, Do Youn

    2016-01-01

    Human sparganosis is a rare parasitic disease caused by infection with the tapeworm Sparganum, the migrating plerocercoid (second stage) larva of Spirometra species. Sparganosis usually involves subcutaneous tissues and/or muscles of various parts of the body, but involvement of other sites such as the brain, eye, peritoneopleural cavity, urinary track, scrotum, and abdominal viscera has also been documented. Infections caused by sparganum have a worldwide distribution but are most common in Southeast Asia such as China, Japan, and South Korea. Rectal sparganosis is an uncommon disease but should be considered in the differential diagnosis of unusual and suspicious rectal submucosal tumors. We report a case of rectal sparganosis presenting as rectal submucosal tumor. We performed endoscopic submucosal dissection of the rectal submucosal tumor. The sparganosis was confirmed based on the presence of calcospherules in the submucosal layer on histological examination. Moreover, the result of the immunoglobulin G antibody test for sparganosis was positive but became negative after endoscopic submucosal dissection. Though rare, rectal sparganosis should be considered in the differential diagnosis of rectal submucosal tumor-like lesions. This case suggests that physicians should make effort to exclude sparganosis through careful diagnostic approaches, including detailed history taking and serological tests for parasites. In this report, we aimed to highlight the clinical presentation of Sparganum infection as a rectal submucosal tumor. PMID:27217709

  13. Endoscopic resection of sparganosis presenting as colon submucosal tumor: A case report.

    PubMed

    Kim, Joong Keun; Baek, Dong Hoon; Lee, Bong Eun; Kim, Gwang Ha; Song, Geun Am; Park, Do Youn

    2016-05-21

    Human sparganosis is a rare parasitic disease caused by infection with the tapeworm Sparganum, the migrating plerocercoid (second stage) larva of Spirometra species. Sparganosis usually involves subcutaneous tissues and/or muscles of various parts of the body, but involvement of other sites such as the brain, eye, peritoneopleural cavity, urinary track, scrotum, and abdominal viscera has also been documented. Infections caused by sparganum have a worldwide distribution but are most common in Southeast Asia such as China, Japan, and South Korea. Rectal sparganosis is an uncommon disease but should be considered in the differential diagnosis of unusual and suspicious rectal submucosal tumors. We report a case of rectal sparganosis presenting as rectal submucosal tumor. We performed endoscopic submucosal dissection of the rectal submucosal tumor. The sparganosis was confirmed based on the presence of calcospherules in the submucosal layer on histological examination. Moreover, the result of the immunoglobulin G antibody test for sparganosis was positive but became negative after endoscopic submucosal dissection. Though rare, rectal sparganosis should be considered in the differential diagnosis of rectal submucosal tumor-like lesions. This case suggests that physicians should make effort to exclude sparganosis through careful diagnostic approaches, including detailed history taking and serological tests for parasites. In this report, we aimed to highlight the clinical presentation of Sparganum infection as a rectal submucosal tumor. PMID:27217709

  14. Thoracoscopic examination of empyema in a patient with sparganosis mansoni.

    PubMed

    Takeda, Keita; Suzuki, Junko; Nagai, Hideaki; Watanabe, Kaoru; Yokoyama, Akira; Ando, Takahiro; Suzuki, Jun; Ohshima, Nobuharu; Masuda, Kimihiko; Tamura, Atsuhisa; Akagawa, Shinobu; Kitani, Masashi; Hebisawa, Akira; Matsui, Hirotoshi; Kobayashi, Nobuyuki; Maruyama, Haruhiko; Ohta, Ken

    2016-02-01

    A 27-year-old man was admitted to our hospital with right pleural effusion. He had suffered from right chest and back pain and a high fever for one week prior to the admission. He had been treated with clarithromycin without improvement. Since thoracoscopy under local anesthesia revealed purulent effusion, synechiae and fibrous septa in the thoracic cavity, synechiotomy was performed and we started antibiotic treatment with the diagnosis of acute bacterial empyema. At the same time, we also suspected parasitic infection because of massive eosinophilic infiltration in pleural effusion and his dietary history of eating raw frogs. During the course of the disease, he had an infiltration in the right lower lobe and pneumothorax. Finally, we diagnosed him with sparganosis mansoni because his serum as well as pleural effusion was positive for the binding to sparganosis mansoni plerocercoid antigen, without any positive findings in bacteriology. His pleural effusion and lung infiltration were resolved after the administration of a high-dose praziquantel. We report this rare parasitic empyema with findings by thoracoscopic examination. PMID:26603428

  15. [Lipedema: a misdiagnosed entity].

    PubMed

    Vignes, S

    2012-07-01

    Lipedema is a clinical entity frequently misdiagnosed or confound with primary lymphedema. Lipedema is a disorder of adipose tissue that occurs almost exclusively in obese women. It is characterized by bilateral enlargement from hip to ankle due to abnormal depositions of subcutaneous fat associated with often mild edema, usually sparing the feet. Disease onset is usually at or soon after puberty. Lipedema results in considerable frustration and distress resulting from the cosmetic appearance. Patients may complain of pain, tenderness, easy bruising of the affected areas with moderate to severe sensitivity to digital pressure or pinching. Imaging studies using computed tomography, magnetic resonance imaging, ultrasound, lymphoscintigraphy are not indicated, except if the diagnosis is atypic or doubtful. Long-term evolution may alter lymphatic system and lead to a lipo-lymphedema with specific complications such as cellulitis. Lipedema management is not codified and included weight loss (poorly improving leg appearance or discomfort), psychological counselling and compression therapy. Liposuction, especially using tumescent local anaesthesia, may reduce edema, spontaneous pain, sensitivity to pressure, bruising and improve appearance resulting in a important increase in quality of life. PMID:22698628

  16. Molecular Diagnosis of Subcutaneous Spirometra erinaceieuropaei Sparganosis in a Japanese Immigrant

    PubMed Central

    Tappe, Dennis; Berger, Luise; Haeupler, Alexandra; Muntau, Birgit; Racz, Paul; Harder, Yves; Specht, Katja; Prazeres da Costa, Clarissa; Poppert, Sven

    2013-01-01

    We report a case of subcutaneous sparganosis in a 68-year-old female Japanese immigrant in Germany. The patient complained of a painless erythema caudal of the umbilicus with a palpable subcutaneous cherry-sized lump. Polymerase chain reaction on formalin-fixed parasite tissue identified Spirometra erinaceieuropaei as the causative agent; the proliferative form of sparganosis, which is caused by the branching and disseminating Sparganum proliferum, could, thus, be excluded. From the excised sparganum, an immunofluorescence test was established and revealed an antibody response directed against the parasite's tegument. Histological key features of the plerocercoid that facilitate diagnosis with different stains are presented. PMID:23166198

  17. A misdiagnosed nail bed melanoma.

    PubMed

    Elloumi-Jellouli, Amel; Triki, Salma; Driss, M; Derbel, F; Zghal, Mohammed; Mrad, K; Rhomdhnane, Kh Ben

    2010-01-01

    Nail bed melanoma or subungual melanoma is frequently misdiagnosed compared to other melanoma in other anatomic sites. We report the case of a 48-year-old woman presenting with a dystrophic and pigmented lesion of her fourth finger nail. This initial presentation had been mistaken for onychomycosis, but biopsy of nail bed and nail matrix confirmed nail bed melanoma. This case is presented to help increase the awareness of atypical presentations of acral melanoma. PMID:20673541

  18. Morphogenesis of the C. elegans vulva

    PubMed Central

    Schindler, Adam J

    2012-01-01

    Understanding how cells move, change shape, and alter cellular behaviors to form organs, a process termed morphogenesis, is one of the great challenges of developmental biology. Formation of the C. elegans vulva is a powerful, simple, and experimentally accessible model for elucidating how morphogenetic processes produce an organ. In the first step of vulval development, three epithelial precursor cells divide and differentiate to generate 22 cells of seven different vulval subtypes. The 22 vulval cells then rearrange from a linear array into a tube, with each of the seven cell types undergoing characteristic morphogenetic behaviours that construct the vulva. Vulval morphogenesis entails many of the same cellular activities that underlie organogenesis and tissue formation across species, including invagination, lumen formation, oriented cell divisions, cell-cell adhesion, cell migration, cell fusion, extracellular matrix remodelling and cell invasion. Studies of vulval development have led to pioneering discoveries in a number of these processes and are beginning to bridge the gap between the pathways that specify cells and their connections to morphogenetic behaviors. The simplicity of the vulva and the experimental tools available in C. elegans will continue to make vulval morphogenesis a powerful paradigm to further our understanding of the largely mysterious mechanisms that build tissues and organs. PMID:23418408

  19. Characterization of Spirometra erinaceieuropaei Plerocercoid Cysteine Protease and Potential Application for Serodiagnosis of Sparganosis

    PubMed Central

    Liu, Li Na; Wang, Zhong Quan; Zhang, Xi; Jiang, Peng; Qi, Xin; Liu, Ruo Dan; Zhang, Zi Fang; Cui, Jing

    2015-01-01

    Background Sparganosis is a neglected but important food-borne parasitic zoonosis. Clinical diagnosis of sparganosis is difficult because there are no specific manifestations. ELISA using plerocercoid crude or excretorysecretory (ES) antigens has high sensitivity but has cross-reactions with other helminthiases. The aim of this study was to characterize Spirometra erinaceieuropaei cysteine protease (SeCP) and to evaluate its potential application for serodiagnosis of sparganosis. Methodology/Principal Findings The full length SeCP gene was cloned, and recombinant SeCP (rSeCP) was expressed and purified. Western blotting showed that rSeCP was recognized by the serum of sparganum-infected mice, and anti-rSeCP serum recognized the native SeCP protein of plerocercoid crude or ES antigens. Expression of SeCP was observed at plerocercoid stages but not at the adult and egg stages. Immunolocalization identified SeCP in plerocercoid tegument and parenchymal tissue. The rSeCP had CP activity, and the optimum pH and temperature were 5.5 and 37C, respectively. Enzymatic activity was significantly inhibited by E-64. rSeCP functions to degrade different proteins and the function was inhibited by anti-rSeCP serum and E-64. Immunization of mice with rSeCP induced Th2-predominant immune responses and anti-rSeCP antibodies had the potential capabilities to kill plerocercoids in an ADCC assay. The sensitivity of rSeCP-ELISA and ES antigen ELISA was 100% when performed on sera of patients with sparganosis. The specificity of rSeCP-ELISA and ES antigen ELISA was 98.22% (166/169) and 87.57% (148/169), respectively (P<0.05). Conclusions The rSeCP had the CP enzymatic activity and SeCP seems to be important for the survival of plerocercoids in host. The rSeCP is a potential diagnostic antigen for sparganosis. PMID:26046773

  20. Aggressive "breast-like" adenocarcinoma of vulva.

    PubMed

    Di Bonito, L; Patriarca, S; Falconieri, G

    1992-02-01

    A case of vulvar adenocarcinoma seen in a 42-year-old woman is reported. The tumor involved the right labium majus and diffusely spread into the surrounding soft tissues as well as the inguinal lymph nodes and was histologically composed of nests, cords, and tubular formations recalling an aggressive duct carcinoma of breast. Likewise, tumor cells exhibited positivity for common breast tumor markers, such as epithelial membrane antigen, carcinoembryonic antigen, and glandular keratins. The possible origin of the neoplasm from mammary ectopic tissue in vulva or from vulvar skin adnexa is briefly discussed. PMID:1594493

  1. Retrospective epidemiological analysis of sparganosis in mainland China from 1959 to 2012.

    PubMed

    Lu, G; Shi, D-Z; Lu, Y-J; Wu, L-X; Li, L-H; Rao, L-Y; Yin, F-F

    2014-12-01

    In this study, epidemiological factors of sparganosis cases reported in mainland China from 1959 to December 2012 were analysed. A total of 1061 valid cases were distributed throughout most of the provinces of mainland China, with most cases occurring in Southern and Eastern China. The average age of patients was 29 years (range 0-80 years). Modes of transmission to humans were via contact (54·6%), mainly by application of frog meat as a poultice, foodborne (33·8%), mainly through ingesting frogs or snakes, and waterborne (11·5%) through drinking raw water. The tissue/organs involved were subcutaneous/muscle (43·1%), eyes (31·0%), central nervous system (CNS) (17·9%), urogenital system (3·9%) and visceral organs (3·2%). Obvious differences existed in main risk factors for different areas. Close correlation was found between tissue/organs and risk factors. Main modes of transmission changed during the past decades, from contact (83·8% pre-1979) to foodborne (63·9% post-2000). The tissue/organs involved also changed at the same time. Cases involving eyes fell from 50·0% pre-1979 to 8·3% post-2000, and cases involving CNS increased from 0% pre-1979 to 47·8% post-2000. These results illustrate that China is one of the main epidemic countries of sparganosis in the world. Consumption of frog/snake meat was the main risk factor, although application of frog flesh as a poultice was the main risk factor before 2000. Sparganosis has become one of the neglected but important foodborne/waterborne parasitic diseases in mainland China. PMID:25372227

  2. Carcinoma of the vulva: epidemiology and pathogenesis.

    PubMed

    Crum, C P

    1992-03-01

    Vulvar squamous carcinoma is an uncommon neoplasm that afflicts a spectrum of women and has been associated with granulomatous vulvar diseases, human papillomaviruses (HPVs), and chronic inflammatory disorders of the vulva. This review summarizes the epidemiologic, histopathologic, and viral data supporting the division of invasive vulvar carcinomas into distinct subsets. Although HPVs have received attention as etiologic agents, histopathologic and viral data indicate that a substantial proportion of vulvar carcinomas in this country may not be related to a veneareally transmitted agent. One of the principal challenges is to produce studies integrating the various disciplines in order to place HPV in proper perspective and develop strategies to identify women at risk for vulvar carcinomas that are not associated with this virus. PMID:1310806

  3. Extraskeletal myxoid chondrosarcoma of the vulva: A case report

    PubMed Central

    VILLERT, ALISA; KOLOMIETS, LARISA; VASILYEV, NIKOLAY; PERELMUTER, VLADIMIR; SAVENKOVA, OLGA

    2015-01-01

    Extraskeletal myxoid chondrosarcoma (ESMC) of the vulva is an extremely rare tumor and currently, there is little available information on its biological behavior and treatment strategy. The present study reports a case of recurrent ESMC of the vulva in a 32-year-old female. The patient presented with an increasingly painful mass of the right vulva, at the site of an exision which had been performed 7-months previously. The tumor mass was histopathologically diagnosed as primary ESMC of the vulva and subsequently, vulvectomy was performed. Cytological examination showed negative surgical margins. Intraoperative radiation therapy at a single dose of 10 Gy was administered to the bed of the removed tumor. The patient refused chemotherapy and five months after surgery, a new lesion was identified in the inguinal region. Bilateral inguinal-femoral lymph node dissection was performed and external beam radiation therapy at a dose of 40 Gy was administered to the inguinal region. Follow-up examination seven months after surgery revealed no evidence of disease progression and at present, the patient remains alive. This study highlights the importance of analyzing each clinical case of ESMC as this may lead to the development of guidelines for the optimal treatment of this rare tumor. PMID:26622802

  4. Darier's disease misdiagnosed as severe seborrheic dermatitis.

    PubMed

    Schwartz, Jessica L; Clinton, Tony S

    2011-12-01

    Darier's disease is a rare autosomal disorder resulting in characteristic findings of the skin, nails, and mucous membranes. Darier's disease is commonly misdiagnosed as seborrheic dermatitis or eczema. We present the case of a young adult active duty Air Force member with 5 years of skin complaints. The 23-year-old patient had been treated for seborrheic dermatitis and eczema with a variety of oral and topical treatments, which did not result in improvement of his symptoms. Upon referral to dermatology, the dermatologist noted skin, nail, and mucous membrane findings consistent with Darier's disease. A skin biopsy histologically confirmed the presence of Darier's disease and treatment was started. Although the course of the disease cannot be stopped, the patient's symptoms did reduce with the appropriate treatment. This case highlights the importance of revisiting the original diagnosis when conventional treatment fails to improve the disease course. PMID:22338367

  5. Cases of pediatric narcolepsy after misdiagnoses.

    PubMed

    Kauta, Shilpa R; Marcus, Carole L

    2012-11-01

    Narcolepsy is characterized by recurrent brief attacks of irresistible sleepiness. Signs can begin during childhood. However, diagnoses are frequently delayed by 10-15 years because of unfamiliarity with pediatric narcolepsy and variable presentations of its associated features (cataplexy, hypnagogic/hypnopompic hallucinations, and sleep paralysis). Therefore, patients may remain untreated during their formative years. Three children with narcolepsy who were initially misdiagnosed are described. Each child's signs were initially related to depression, hypothyroidism, jaw dysfunction, or conversion disorder. However, after a multiple sleep latency test, the diagnosis of narcolepsy was established. All three patients were treated appropriately with stimulant medications, selective serotonin reuptake inhibitors, or sodium oxybate, and demonstrated positive responses. Although no definitive cure exists for narcolepsy, early recognition and appropriate symptomatic treatment with medications can allow affected children to improve quality of life and achieve normality, both academically and socially. PMID:23044019

  6. Postpartum septic sacroiliitis misdiagnosed as sciatic neuropathy.

    PubMed

    Liu, Xiao-Qing; Li, Fang-Cai; Wang, Jia-Wei; Wang, Shuang

    2010-03-01

    Early diagnosis of septic sacroiliitis is difficult because symptoms are nonspecific, especially during pregnancy and the postpartum period. We describe a female patient with left buttock pain radiating down the thigh after an uncomplicated induction delivery. She was afebrile and had no apparent abnormality on pelvic x-ray or computed tomography scan. A sensory deficit in the lateral portion of her left lower limb was found, and electromyography showed neurogenic abnormalities in the left lower limb. She was initially misdiagnosed as sciatic neuropathy. As her symptoms worsened, septic sacroiliitis is considered. Bone scintigraphy showed increased Tc-methylene diphosphonate uptake in the left sacroiliac joint, and magnetic resonance imaging scan showed a signal abnormality in the left sacroiliac joint. The diagnosis of septic sacroiliitis was then confirmed by the rapid efficacy of antibiotic therapy. This report suggests that irritation and injury of spinal nerves can be the presenting signs in septic sacroiliitis. PMID:20090512

  7. Management of radionecrosis of the vulva and distal vagina

    SciTech Connect

    Roberts, W.S.; Hoffman, M.S.; LaPolla, J.P.; Ruas, E.; Fiorica, J.V.; Cavanagh, D. )

    1991-05-01

    Twelve patients were seen between January 1983 and June 1989 with the clinical diagnosis of radionecrosis of the vulva or distal vagina. Seven patients received radiation for vulvar cancer, three for distal vaginal cancer, and two for recurrent endometrial cancer. No patient healed spontaneously and the mean delay in surgical therapy was 8.5 months. The radionecrotic site was treated with local therapy, radical local excision (with or without colostomy), or exenteration. The operative defect was closed primarily in three patients and covered with local flaps or myocutaneous flaps in seven patients. The two patients with local care still have radionecrotic ulcers. One of three patients who were closed primarily continues to have an ulcer. All other patients have healed satisfactorily except one who died after two attempts to correct the problem. Radionecrosis of the vulva and distal vagina should generally be treated surgically.

  8. Primary breast adenocarcinoma in ectopic breast tissue in the vulva.

    PubMed

    McMaster, Jason; Dua, Anahita; Dowdy, Sean C

    2013-01-01

    Introduction. Accessory breast tissue is a rare finding in the general population with an incidence of 1-2%. An even rarer occurrence is accessory breast tissue afflicted with breast carcinoma. We present a brief report discussing diagnosis and management of a patient who presented with primary breast adenocarcinoma in vulval supranumerary tissue. Brief Report. A 60-year-old Caucasian female presented with a lesion in her left vulva that she first identified during adolescence. The lesion began to grow and ulcerate prompting her to receive treatment. Biopsy was inconclusive, and metastatic workup was negative, so her lesion was treated as an isolated breast lump and removed via wide local excision. Conclusion. Primary breast adenocarcinoma of the vulva is exceedingly rare. A paucity of the literature on this topic unfortunately means that strong evidence does not exist detailing the best management of this patient cohort. However, given that histological data confirms these cancers are virtually the same as breast cancers, it logically follows that the best treatment practices for breast cancer may be applied to treat these patients presenting with primary vulva cancers of ectopic breast tissue. PMID:24066246

  9. Anatomy of the Vulva and the Female Sexual Response.

    PubMed

    Yeung, Jennifer; Pauls, Rachel N

    2016-03-01

    The female vulva is an intricate structure comprising several components. Each structure has been described separately, but the interplay among them and physiologic significance remain controversial. The structures extend inferiorly from the pubic arch and include the mons pubis, labia majora, labia minora, vestibule, and clitoris. The clitoris is widely accepted as the most critical anatomic structure to female sexual arousal and orgasm. The female sexual response cycle is also very complex, requiring emotional and mental stimulation in addition to end organ stimulation. PMID:26880506

  10. Torsion of a Large Appendix Testis Misdiagnosed as Pyocele

    PubMed Central

    Meher, Susanta; Rath, Satyajit; Sharma, Rakesh; Sasmal, Prakash Kumar; Mishra, Tushar Subhadarshan

    2015-01-01

    Torsion of the appendix testis is not an uncommon cause of acute hemiscrotum. It is frequently misdiagnosed as acute epididymitis, orchitis, or torsion of testis. Though conservative management is the treatment of choice for this condition, prompt surgical intervention is warranted when testicular torsion is suspected. We report a case of torsion of a large appendix testis misdiagnosed as pyocele. Emergency exploration of it revealed a large appendix testis with torsion and early features of gangrene. After excision of the appendix testis, the wound was closed with an open drain. The patient had an uneventful and smooth postoperative recovery. PMID:25861514

  11. Protruding vulva mutants identify novel loci and Wnt signaling factors that function during Caenorhabditis elegans vulva development.

    PubMed Central

    Eisenmann, D M; Kim, S K

    2000-01-01

    The Caenorhabditis elegans vulva develops from the progeny of three vulval precursor cells (VPCs) induced to divide and differentiate by a signal from the somatic gonad. Evolutionarily conserved Ras and Notch extracellular signaling pathways are known to function during this process. To identify novel loci acting in vulval development, we carried out a genetic screen for mutants having a protruding-vulva (Pvl) mutant phenotype. Here we report the initial genetic characterization of several novel loci: bar-1, pvl-4, pvl-5, and pvl-6. In addition, on the basis of their Pvl phenotypes, we show that the previously identified genes lin-26, mom-3/mig-14, egl-18, and sem-4 also function during vulval development. Our characterization indicates that (1) pvl-4 and pvl-5 are required for generation/survival of the VPCs; (2) bar-1, mom-3/mig-14, egl-18, and sem-4 play a role in VPC fate specification; (3) lin-26 is required for proper VPC fate execution; and (4) pvl-6 acts during vulval morphogenesis. In addition, two of these genes, bar-1 and mom-3/mig-14, are known to function in processes regulated by Wnt signaling, suggesting that a Wnt signaling pathway is acting during vulval development. PMID:11063687

  12. Non-leukemic myeloid sarcoma involving the vulva, vagina, and cervix: a case report and literature review

    PubMed Central

    Yu, Yuan; Qin, Xuemei; Yan, Shuxin; Wang, Wenxia; Sun, Yanlin; Zhang, Maohong

    2015-01-01

    Myeloid sarcoma (MS) is defined as a tumor mass consisting of myeloid blast with or without maturation occurring at an anatomical site other than bone marrow with normal architectural effacement. It can also precede the onset of leukemia which is called non-leukemic MS. Non-leukemic MS is a kind of rare disease and easy to be misdiagnosed as other common malignancies due to the rarity and nonspecific manifestation. We herein report an unusual case of non-leukemic MS involving the vulva, vagina, and cervix in a female patient. The bone marrow aspiration and biopsy of the patient revealed no hematological abnormality. Immunohistochemical staining of the biopsies was strongly positive for myeloperoxidase, CD68, leukocyte common antigen (LCA), CD117, CD34, CD38, CD79a, and negative for cytokeratin (CK), epithelial memberane antigen (EMA), CD2, CD3, CD20, CD5, CD138. Then a diagnosis of non-leukemic MS was made. Unfortunately, our patient received only one cycle of chemotherapy consisting of cytosine arabinoside and daunorubicin, then refused any further treatment and died 4 months after diagnosis. Although systemic chemotherapy is widely accepted to be a promising strategy, its benefit still needs to be further assessed. Certain questions still need to be answered for this disease: 1) Why can approximately 20% of the patients with non-leukemic MS remain disease-free after local therapy alone? 2) How many cycles of chemotherapy are needed for these patients after achievement of complete remission? 3) What are the prognostic or risk factors in these patients who have no abnormality of karyotype, fusion genes, or gene mutation to predict responsiveness to chemotherapy and outcome? 4) What is the risk factor for relapse? The rarity of non-leukemic MS makes it almost impossible to conduct large-scale randomized trials, but judicious study for each patient with MS is helpful for a further understanding of the nature of the disease. PMID:26677338

  13. Congenital hernia of cord: an often misdiagnosed entity.

    PubMed

    Raju, Rubin; Satti, Mohamed; Lee, Quoc; Vettraino, Ivana

    2015-01-01

    Congenital hernia of the cord, also known as umbilical cord hernia, is an often misdiagnosed and under-reported entity, easily confused with a small omphalocele. It is different from postnatally diagnosed umbilical hernias and is believed to arise from persistent physiological mid-gut herniation. Its incidence is estimated to be 1 in 5000. Unlike an omphalocele, it is considered benign and is not linked with chromosomal anomalies. It has been loosely associated with intestinal anomalies, suggesting the need for a complete fetal anatomical ultrasound evaluation. We present a case of a fetal umbilical cord hernia diagnosed in a 28-year-old woman at 21 weeks gestation. The antenatal and intrapartum courses were uncomplicated. It was misdiagnosed postnatally as a small omphalocele, causing unwarranted anxiety in the parents. Increased awareness and knowledge of such an entity among health professionals is important to prevent unwarranted anxiety from misdiagnosis, and inadvertent bowel injury during cord clamping at delivery. PMID:25899514

  14. Familial cleidocranial dysplasia misdiagnosed as rickets over three generations.

    PubMed

    Franceschi, Roberto; Maines, Evelina; Fedrizzi, Michela; Piemontese, Maria Rosaria; De Bonis, Patrizia; Agarwal, Nivedita; Bellizzi, Maria; Di Palma, Annunziata

    2015-10-01

    Cleidocranial dysplasia (CCD) is a rare autosomal dominant skeletal dysplasia characterized by hypoplastic clavicles, late closure of the fontanels, dental problems and other skeletal features. CCD is caused by mutations, deletions or duplications in runt-related transcription factor 2 (RUNX2), which encodes for a protein essential for osteoblast differentiation and chondrocyte maturation. We describe three familial cases of CCD, misdiagnosed as rickets over three generations. No mutations were detected on standard DNA sequencing of RUNX2, but a novel deletion was identified on quantitative polymerase chain reaction (qPCR) and multiple ligation-dependent probe amplification (MLPA). The present cases indicate that CCD could be misdiagnosed as rickets, leading to inappropriate treatment, and confirm that mutations in RUNX2 are not able to be identified on standard DNA sequencing in all CCD patients, but can be identified on qPCR and MLPA. PMID:26286462

  15. Emergency laparotomy for misdiagnosed biliary cystadenoma originating from caudate lobe

    PubMed Central

    Ramacciato, Giovanni; Nigri, Giuseppe R; D'Angelo, Francesco; Aurello, Paolo; Bellagamba, Riccardo; Colarossi, Cristina; Pilozzi, Emanuela; Del Gaudio, Massimo

    2006-01-01

    Background Biliary cystadenoma is a rare benign neoplasm, which is often misdiagnosed for a hepatic abscess or a hydatid cyst that tends to recur and is at risk for progression to malignant neoplasm. Case presentation This case describes a 30-year-old woman admitted to our institution in an emergency setting. The patient was originally misdiagnosed as affected by a hepatic hydatid cyst at another hospital, and then emergently treated at our Institution for severe abdominal pain. Histologic evaluation of the cyst showed that it was a biliary cystadenoma and, therefore, the patient underwent a hepatic resection in order to completely remove the lesion. Conclusion Complete excision of any suspicious hepatic cystic lesion remains the best method for diagnosis and treatment of cystadenoma. Incomplete excision of most biliary cystadenoma results in a higher rate of recurrence and the risk of malignant transformation. We report this case to elucidate the clinical presentation, preoperative evaluation, and surgical treatment of these rare lesions. PMID:17090300

  16. Aggressive Angiomyxoma of the Vulva: A Bizarre Perineal Lesion

    PubMed Central

    Zizi-Sermpetzoglou, Adamantia; Myoteri, Despoina; Koulia, Kalliroi; Kontostolis, Vassilios; Moschouris, Hippokratis; Dellaportas, Dionysios

    2015-01-01

    Introduction. Aggressive angiomyxoma is a rare, slowly growing, and benign tumour of mesenchymal origin, which affects women of reproductive age and is associated with a high risk of local recurrence. Case Presentation. A case of a 47-year-old white female is presented herein, with a large polypoid, gelatinous mass on the right labia majora, measuring 26 × 21 × 6 cm. Histopathologically, the lesion was composed of spindle and stellate-shaped cells embedded in a myxoid matrix. Another specific feature was the presence of variable-sized thin-walled capillaries and thick-walled vascular channels. The patient underwent wide local excision of the tumour with clear margins and developed local recurrence 18 months later. Discussion. Aggressive angiomyxoma of the vulva needs to be distinguished from benign myxoid tumors with a low risk of local recurrence as well as from malignant myxoid neoplasms. Usually wide local excision with tumour-free margins and occasionally hormonal manipulation is the treatment of choice. PMID:25977826

  17. Paget Disease of the Vulva: Diagnosis by Immunohistochemistry

    PubMed Central

    Gonalves Amorim, Andressa; Batista Fraga Mendes, Brunelle; Neves Ferreira, Rodrigo; Chamb Filho, Antnio

    2015-01-01

    The objective of this paper is to report a case of extramammary Paget disease of the vulva, to describe its diagnosis, surgical treatment, and outcome, and to discuss the general characteristics of this pathology. This is a rare neoplasm, found principally in areas in which apocrine and eccrine glands are numerous. This case report is relevant to the literature since the differential diagnosis of extramammary Paget disease is difficult to be done only with the macroscopic appearance of the lesion and even with the microscopic characteristics, requiring further studies, immunohistochemistry, as to differentiate pathologies. The present report describes the case of a 63-year-old patient at the Santa Casa de Misericrdia Hospital in Vitria, Esprito Santo, Brazil, who presented with a hardened, ulcerated, and purplish lesion with hyperchromic and hypochromic spots, measuring 4?cm in diameter, located on the lower third of right labium majus, close to the vaginal fourchette. A right hemivulvectomy was performed, leaving wide margins all around. The patient progressed satisfactorily following surgery. Although extramammary Paget disease is rare, its incidence increases as a function of the patient's age. Patients should be followed up closely because of the risk of persistence and/or recurrence of the disease. PMID:26060586

  18. Involuntary movements misdiagnosed as seizure during vitamin B12 treatment.

    PubMed

    Carman, Kursat Bora; Belgemen, Tugba; Yis, Uluc

    2013-11-01

    Seizures and epilepsy are a common problem in childhood. Nonepileptic paroxysmal events are conditions that can mimic seizure and frequent in early childhood. Nonepileptic paroxysmal events can be due to physiological or exaggerated physiological responses, parasomnias, movement disorders, behavioral or psychiatric disturbances, or to hemodynamic, respiratory, or gastrointestinal dysfunction. Vitamin B12 deficiency is a treatable cause of failure to thrive and developmental regression, involuntary movements, and anemia. Involuntary movements rarely may appear a few days after the initiation of vitamin B12 treatments and might be misdiagnosed as seizure. Here, we report 2 patients who presented with involuntary movements with his video image. PMID:24196096

  19. Angiogenesis in Paget's Disease of the Vulva and the Breast: Correlation with Microvessel Density

    PubMed Central

    Ellis, Patricia E.; MacLean, Allan B.; Wong Te Fong, L. F.; Crow, Julie C.; Perrett, Christopher W.

    2012-01-01

    Our understanding of the pathogenesis of Paget's disease of the vulva and the breast remains limited. Current evidence supports the fact that angiogenesis plays an important role in the pathogenesis of several diseases. Therefore, we sought to define its role, as correlated with microvessel density, in Paget's disease of the vulva and the breast. Microvessels were analysed using anti-von Willebrand factor antibody in 105 cases of Paget's disease of the vulva and the breast comprising 71 cases of Paget's disease of the vulva, including 8 cases with invasive disease, and 34 cases of Paget's disease of the breast. The latter included 12 cases with DCIS, 5 cases with both DCIS and invasive carcinoma, and 6 with carcinoma alone. Eleven cases had no underlying tumour identified. Increased microvessel density was demonstrated in Paget's disease of the breast with DCIS and with carcinoma alone compared to Paget's disease of the breast alone, P < 0.08 and P < 0.013, respectively. There were no significant differences in microvessel density in the vulval cases. Neovascularisation is an important process in the development of Paget's disease of the breast. Other biological and molecular processes are more involved in the pathogenesis of Paget's disease of the vulva. PMID:22545050

  20. The Endemic Mimic: Blastomycosis An Illness Often Misdiagnosed

    PubMed Central

    Bradsher, Robert W.

    2014-01-01

    One of the endemic fungi, Blastomyces dermatitidis, can cause epidemics of infection with multiple persons involved in a point source outbreak but more commonly causes sporadic cases of infection within the areas of endemicity. Blastomycosis can present as an acute pneumonia which is often misdiagnosed as acute pneumococcal pneumonia or the infection may present as a chronic pneumonia along with weight loss, night sweats, hemoptysis, and a lung mass suggesting tuberculosis or carcinoma of the lung. Extrapulmonary infection with B. dermatitidis is protean with many different manifestations. Most commonly, skin or subcutaneous lesions are found with either a verrucous or warty appearance or in an ulcerative form. Cases have been misidentified as keratoacanthoma, pyoderma gangrenosum, carcinoma, or as Weber-Christian panniculitis if there are nodular subcutaneous lesions. Essentially any site or organ can have lesions of disseminated blastomycosis. In our series, cases of laryngeal carcinoma, adrenal insufficiency, thyroid nodules, granulomatous hypercalcemia, abnormal mammograms thought to represent breast carcinoma, otitis media with cranial extension, immune thrombocytopenic purpura, and hemolytic anemia of unknown cause have been misdiagnosed and blastomycosis subsequently identified as the cause. This infection causes manifestations which mimic many other more commonly diagnosed conditions and must always be considered by clinicians practicing in the endemic region. PMID:25125734

  1. Syringoma of vulva: an unusual presentation. Clinical, morphological and immunohistochemical aspects.

    PubMed

    Núñez-Troconis, José; Viloria de Alvarado, María Elena

    2015-03-01

    The case of a 34-year-old woman, who consulted because she observed the appearance of numerous yellow-white asymptomatic papules on the vulva, is presented. Clinical diagnosis of syringoma of vulva was established. The pathological and immunohistochemical studies confirmed the diagnosis. Vulvar syringoma usually occurs as a multiple flesh-colored or brownish papules on both sides of labia majora of women in their third decade. Its diagnosis should be considered when the patient complaints of vulvar pruritus and/or sweating. PMID:25920186

  2. Mammary-like adenocarcinoma of the vulva associated to Paget's disease: a case report.

    PubMed

    Meddeb, Sawsen; Rhim, Mohamed Salah; Mestiri, Sarra; Kouira, Mouna; Bibi, Mohamed; Khairi, Hedi; Yacoubi, Mohamed Tahar

    2014-01-01

    Mammary-like adenocarcinoma of the vulva associated to Paget's disease is exceedingly rare. So, it is very important to perform all the pathological and immunohistochemical investigations to achieve differential diagnosis from both a metastatic lesion from an orthotopic breast cancer and a vulvar adnexal tumor. This report describes a case of vulvar Paget's disease associated with underlying mammary-like adenocarcinoma diagnosed in the Department of Obstetrics and Gynecology of Farhat Hached university hospital of Sousse in Tunisia. We also review previously reported cases of primary breast-like carcinoma of the vulva with or without Paget's disease. PMID:25848451

  3. Verrucous Carcinoma of the Vulva: A Case Report and Review of the Literature

    PubMed Central

    Bouquet de Jolinière, Jean; Khomsi, F.; Gothuey, J. M.; Guillou, L.; Fadhlaoui, A.; Dubuisson, J. B.; Feki, A.

    2016-01-01

    Verrucous carcinoma of the vulva is a rare lesion (1). Affecting essentially postmenopausal women, this lesion is a distinct and particular entity in vulval carcinoma classification and its scalability is uncertain and unpredictable. Here, we present a case concerning a 48-year-old patient, without follow-up after a condyloma acuminate of the vulva (large left lip). The origin of this case will be discussed in this article. The treatment decided was only surgical. A review of literature shows the rarity of this lesion of the female genital tract. PMID:26904547

  4. HMGA2 expression pattern and TERT mutations in tumors of the vulva.

    PubMed

    Agostini, Antonio; Panagopoulos, Ioannis; Andersen, Hege Kilen; Johannesen, Lene Elisabeth; Davidson, Ben; Trop, Claes Gran; Heim, Sverre; Micci, Francesca

    2015-06-01

    Malignant tumors of the vulva account for only 5% of cancers of the female genital tract in the USA. The most frequent cancers of the vulva are squamous cell carcinoma (SCC) and malignant melanoma (MM). Little is known about the genetic aberrations carried by these tumors. We report a detailed study of 25 vulva tumors [22 SCC, 2 MM, 1 atypical squamous cell hyperplasia (AH)] analyzed for expression of the high-mobility group AT-hook family member genes HMGA2 and HMGA1, for mutations in the IDH1, IDH2 and TERT genes, and for methylation of the MGMT promoter. The RT-PCR and immunohistochemistry analyses showed that HMGA2 was expressed in the great majority of analyzed samples (20 out of 24; SCC as well as MM) but not in the normal controls. HMGA1, on the other hand, was expressed in both tumors and normal tissues. Five of the 24 tumors (all SCC) showed the C228T mutation in the TERT promoter. Our results showed that HMGA2 and TERT may be of importance in the genesis and/or the progression of tumors of the vulva. PMID:25823555

  5. HMGA2 expression pattern and TERT mutations in tumors of the vulva

    PubMed Central

    AGOSTINI, ANTONIO; PANAGOPOULOS, IOANNIS; ANDERSEN, HEGE KILEN; JOHANNESEN, LENE ELISABETH; DAVIDSON, BEN; TROPÉ, CLAES GÖRAN; HEIM, SVERRE; MICCI, FRANCESCA

    2015-01-01

    Malignant tumors of the vulva account for only 5% of cancers of the female genital tract in the USA. The most frequent cancers of the vulva are squamous cell carcinoma (SCC) and malignant melanoma (MM). Little is known about the genetic aberrations carried by these tumors. We report a detailed study of 25 vulva tumors [22 SCC, 2 MM, 1 atypical squamous cell hyperplasia (AH)] analyzed for expression of the high-mobility group AT-hook family member genes HMGA2 and HMGA1, for mutations in the IDH1, IDH2 and TERT genes, and for methylation of the MGMT promoter. The RT-PCR and immunohistochemistry analyses showed that HMGA2 was expressed in the great majority of analyzed samples (20 out of 24; SCC as well as MM) but not in the normal controls. HMGA1, on the other hand, was expressed in both tumors and normal tissues. Five of the 24 tumors (all SCC) showed the C228T mutation in the TERT promoter. Our results showed that HMGA2 and TERT may be of importance in the genesis and/or the progression of tumors of the vulva. PMID:25823555

  6. [Immunotropic agents in therapy of chronic degenerative diseases of the vulva].

    PubMed

    Sharapova, L E; Shul'diakov, A A; Liapina, E P

    2012-01-01

    The prospective randomized study involved 60 patients with chronic dystrophic diseases of the vulva. The clinical efficacy of cycloferon in the complex treatment of the patients and its influence on the psychological and functional state and the dynamics of the life quality were investigation. PMID:22993936

  7. Evolution of robustness in the signaling network of Pristionchus vulva development

    PubMed Central

    Zauner, Hans; Sommer, Ralf J.

    2007-01-01

    Robustness to environmental or genetic perturbation, like any other trait, is affected by evolutionary change. However, direct studies on the interplay of robustness and evolvability are limited and require experimental microevolutionary studies of developmental processes. One system in which such microevolutionary studies can be performed is vulva development in the nematode Pristionchus pacificus. Three vulval precursor cells respond to redundant cellcell interactions, including signals from the gonad and the epidermal cell P8.p. Interestingly, P. pacificus P8.p is involved in cell fate specification of the future vulva cells by lateral inhibition but is incompetent to respond to the inductive signal from the gonad itself. These functional properties of P8.p are unknown from other nematodes, such as Caenorhabditis elegans. We began an experimental and genetic analysis of the microevolution of P8.p function. We show that vulva misspecification events differ between Pristionchus strains and species. Similarly, lateral inhibition and developmental competence of P8.p evolved within the genus Pristionchus and between natural isolates of P. pacificus. Surprisingly, in some recombinant inbred lines of two distinct P. pacificus isolates, P8.p gained competence to form vulva tissue, a trait that was never observed in P. pacificus isolates. Our results suggest differences in developmental stability between natural isolates, and we hypothesize that the remarkable evolvability of redundant cellcell interactions allows for adaptive evolution of robustness to developmental noise. PMID:17551021

  8. Idiopathic Hypertrophic Cranial Pachymeningitis Misdiagnosed as Acute Subtentorial Hematoma

    PubMed Central

    Park, Ik-Seong; Kim, Hoon; Chung, Eun Yong

    2010-01-01

    A case of idiopathic hypertrophic cranial pachymeningitis (IHCP) misdiagnosed as an acute subdural hematoma is reported. A 37-year-old male patient presented with headache following head trauma 2 weeks earlier. Computerized tomography showed a diffuse high-density lesion along the left tentorium and falx cerebri. Initial chest X-rays revealed a small mass in the right upper lobe with right lower pleural thickening, which suggested lung cancer, such as an adenoma or mediastinal metastasis. During conservative treatment under the diagnosis of a subdural hematoma, left cranial nerve palsies were developed (3rd and 6th), followed by scleritis and uveitis involving both eyes. Magnetic resonance imaging (MRI) revealed an unusual tentorium-falx enhancement on gadolinium-enhanced T1-weighted images. Non-specific chronic inflammation of the pachymeninges was noticed on histopathologic examination following an open biopsy. Systemic steroid treatment was initiated, resulting in dramatic improvement of symptoms. A follow-up brain MRI showed total resolution of the lesion 2 months after steroid treatment. IHCP should be included in the differential diagnosis of subtentorial-enhancing lesions. PMID:20856672

  9. Nonclassic congenital adrenal hyperplasia misdiagnosed as Turner syndrome

    PubMed Central

    Mishra, Vineet V.; Pritti, Kumari; Aggarwal, Rohina; Choudhary, Sumesh

    2015-01-01

    We present a patient with nonclassic congenital adrenal hyperplasia (NCAH) misdiagnosed as mosaic Turner syndrome. She presented with complaints of primary infertility. Short stature, the presence of facial hair and hoarse voice was also noted. She had primary amenorrhea and was advised for karyotype at 16 years of age, which was reported as 45, X[20]/46, XX[80], stating her as a case of mosaic Turner syndrome. Clitoroplasty was done at 21 years of age for clitoromegaly, which was noticed during puberty. The diagnosis of mosaic Turner could not explain the virilization. Therefore, we repeated the karyotype, which revealed 46, XX in more than 100 metaphases and was sufficient to exclude mosaicism. Furthermore, the endocrinological evaluation revealed high testosterone level with a normal 17 alpha-hydroxyprogesterone (17-OHP). The presence of pubertal onset virilization with a karyotype of 46, XX and raised testosterone level with normal 17-OHP level, raised the suspicion of NCAH for which adrenocorticotropic hormone stimulation test was done which confirmed the diagnosis of NCAH. PMID:26751945

  10. Misdiagnosing Absent Pedicle of Cervical Spine in the Acute Trauma Setting.

    PubMed

    Abduljabbar, Fahad H; Rossel, Felipe; Nooh, Anas; Jarzem, Peter

    2015-09-28

    Congenital absence of cervical spine pedicle can be easily misdiagnosed as facet dislocation on plain radiographs especially in the acute trauma setting. Additional imaging, including computed tomography (CT)-scan with careful interpretation is required in order to not misdiagnose cervical posterior arch malformation with subsequent inappropriate management. A 39-year-old patient presented to the emergency unit of our university hospital after being trampled by a cow over her back and head followed by loss of consciousness, retrograde amnesia and neck pain. Her initial cervical CT-scan showed possible C5-C6 dislocation, then, it became clear that her problem was a misdiagnosed congenital cervical abnormality. Patient was treated symptomatically without consequences. The congenital absence of a cervical pedicle is a very unusual condition that is easily misdiagnosed. Diagnosis can be accurately confirmed with a CT-scan of the cervical spine. Symptomatic conservative treatment will result in resolution of the symptoms. PMID:26605026

  11. Misdiagnosing Absent Pedicle of Cervical Spine in the Acute Trauma Setting

    PubMed Central

    Rossel, Felipe; Nooh, Anas; Jarzem, Peter

    2015-01-01

    Congenital absence of cervical spine pedicle can be easily misdiagnosed as facet dislocation on plain radiographs especially in the acute trauma setting. Additional imaging, including computed tomography (CT)-scan with careful interpretation is required in order to not misdiagnose cervical posterior arch malformation with subsequent inappropriate management. A 39-year-old patient presented to the emergency unit of our university hospital after being trampled by a cow over her back and head followed by loss of consciousness, retrograde amnesia and neck pain. Her initial cervical CT-scan showed possible C5-C6 dislocation, then, it became clear that her problem was a misdiagnosed congenital cervical abnormality. Patient was treated symptomatically without consequences. The congenital absence of a cervical pedicle is a very unusual condition that is easily misdiagnosed. Diagnosis can be accurately confirmed with a CT-scan of the cervical spine. Symptomatic conservative treatment will result in resolution of the symptoms. PMID:26605026

  12. Preoperative easily misdiagnosed telangiectatic osteosarcoma: clinical–radiologic–pathologic correlations

    PubMed Central

    Gao, Zhen-Hua; Yin, Jun-Qiang; Liu, Da-Wei; Meng, Quan-Fei

    2013-01-01

    Abstract Purpose: To describe the clinical, imaging, and pathologic characteristics and diagnostic methods of telangiectatic osteosarcoma (TOS) for improving the diagnostic level. Materials and methods: The authors retrospectively reviewed patient demographics, serum alkaline phosphatase (AKP) levels, preoperative biopsy pathologic reports, pathologic materials, imaging findings, and treatment outcomes from 26 patients with TOS. Patient images from radiography (26 cases) and magnetic resonance (MR) imaging (22 cases) were evaluated by 3 authors in consensus for intrinsic characteristics. There were 15 male and 11 female patients in the study, with an age of 9–32 years (mean age 15.9 years). Results: Eighteen of 26 patients died of lung metastases within 5 years of follow-up. The distal femur was affected more commonly (14 cases, 53.8%). Regarding serum AKP, normal (8 cases) or mildly elevated (18 cases) levels were found before preoperative chemotherapy. Radiographs showed geographic bone lysis without sclerotic margin (26 cases), cortical destruction (26 cases), periosteal new bone formation (24 cases), soft-tissue mass (23 cases), and matrix mineralization (4 cases). The aggressive radiographic features of TOS simulated the appearance of conventional high-grade intramedullary osteosarcoma, though different from aneurysmal bone cyst. MR images demonstrated multiple big (16 cases) or small (6 cases) cystic spaces, fluid-fluid levels (14 cases), soft-tissue mass (22 cases), and thick peripheral and septal enhancement (22 cases). Nine of 26 cases were misdiagnosed as aneurysmal bone cysts by preoperative core-needle biopsy, owing to the absence of viable high-grade sarcomatous cells in the small tissue samples. Conclusion: The aggressive growth pattern with occasional matrix mineralization, and multiple big or small fluid-filled cavities with thick peripheral, septal, and nodular tissue surrounding the fluid-filled cavities are characteristic imaging features of TOS, and these features are helpful in making the correct preoperative diagnosis of TOS. PMID:24334494

  13. A nonfunctioning parathyroid carcinoma misdiagnosed as a follicular thyroid nodule.

    PubMed

    Cetani, Filomena; Frustaci, Gianluca; Torregrossa, Liborio; Magno, Silvia; Basolo, Fulvio; Campomori, Alberto; Miccoli, Paolo; Marcocci, Claudio

    2015-01-01

    Parathyroid carcinoma (PC) is a rare endocrine malignancy. The tumor is mostly functioning, causing severe primary hyperparathyroidism, with high serum calcium and parathyroid hormone (PTH) levels. Nonfunctioning PC is extremely rare. We report a 50-year-old male patient who was referred to our Department for a right thyroid nodule, incidentally detected on carotid Doppler ultrasound scan, with a fine-needle aspiration cytology showing a follicular lesion. At the time of our evaluation, neck ultrasound showed a 1.3 cm right hypoechoic thyroid nodule with irregular margins and the absence of enlarged bilateral cervical lymph nodes. Thyroid function tests were normal. Serum calcium was normal and plasma PTH slightly above the upper limit of the normal range. The patients underwent right lobectomy. The intraoperative frozen-section pathological examination raised the suspicion of a PC. Definitive histology showed a markedly irregular infiltrative growth of the tumor with invasion of the thyroid tissue and cervical soft tissues. Immunostaining for thyroglobulin was negative, whereas staining for chromogranin A and PTH showed a strong reactivity. Based on the microscopic findings and the immunohistochemical profile, the tumor was diagnosed as a PC. Postoperative serum calcium and phosphate levels were in the normal range. One month after surgery, serum calcium and PTH were normal. Neck ultrasound and total body computed tomography scan were negative for local and metastatic disease. Eight months later, serum calcium was normal and plasma PTH level remained around the upper limit of normal range. Neck ultrasound did not show any pathological lesions. This is the first case of a nonfunctioning sporadic PC misdiagnosed prior of surgery as a follicular thyroid nodule. The parathyroid nature of the neck lesion could not be suspected before surgery. Fine-needle aspiration cytology (FNAC) may fail to distinguish a parathyroid tumor from a benign thyroid nodule because at FNAC, parathyroid and thyroid lesions have some morphological similarities. Histological criteria are not always sufficient for the differential diagnosis, which can definitely be established using immunohistochemistry. PMID:26350418

  14. Unusual benign polypoid and papular neoplasms and tumor-like lesions of the vulva.

    PubMed

    AbdullGaffar, Badr; Keloth, Tasnim R; Raman, Lakshmiah G; Mahmood, Suaad; Almulla, Amal; AlMarzouqi, Mamoun; Al-Hasani, Salam

    2014-04-01

    We aimed to investigate the prevalence and spectrum of unusual benign neoplasms and tumor-like lesions presenting as vulvar polyps and papules, to study their clinical, pathologic, hormonal, and developmental features and whether they have important associations with other pathologic lesions or clinical diseases. We conducted a retrospective review study of 115 vulvar specimens over 7 years. Common lesions, for example, fibroepithelial polyps, skin tags, papillomas, abscesses, viral warts and common cysts, were excluded. We found 21 cases (18%) with uncommon benign vulvar lesions. They included 7 epithelial cysts, 3 vascular lesions, 3 glandular neoplasms, 3 endometrioses, 1 caruncle, 1 pilonidal sinus, 1 prolapsed urethra, 1 seborrheic keratosis, and 1 granular cell tumor. The age range was between 1 and 64 years with a mean age of 33 years. Most (86%) were 2.5 cm or less. Many were asymptomatic incidental pathologic findings that can be missed clinically. Nine cases have important clinical associations or coexisting incidental pathologic lesions. Some lesions demonstrated hormone receptors. Some were clinically confused with fibroepithelial polyps, abscesses, warts, melanocytic lesions, and tumors. In conclusion, although the vulva is a small compartment, its developmental and histologic complexity can result in a variety of unusual and rare benign polypoid and papular lesions, some unique to the vulva, which might present diagnostic challenges to the clinicians and pathologists. In addition, many bear controversy regarding their histogenesis and origin of development in the vulva. PMID:24342664

  15. Presentation of epidermolytic acanthomas as multiple tan papules on the vulva

    PubMed Central

    Fletcher, J. Wesley; Parekh, Palak

    2016-01-01

    Epidermolytic hyperkeratosis is a histological reaction pattern seen in a variety of disease processes, including epidermolytic ichthyosis, Vorner's epidermolytic palmoplantar keratoderma, epidermal nevus, and solitary epidermolytic acanthoma. Here we present the case of a 59-year-old woman with multiple asymptomatic papules on her vulva. Clinical differential diagnoses included condyloma acuminata, seborrheic keratoses, bowenoid papulosis, adnexal tumors, and papular acantholytic dyskeratosis. Shave biopsy revealed findings consistent with epidermolytic hyperkeratosis. This case represents an interesting presentation of focally disseminated vulvar epidermolytic acanthomas and highlights the importance of a biopsy in establishing this diagnosis. PMID:27034569

  16. Presentation of epidermolytic acanthomas as multiple tan papules on the vulva.

    PubMed

    Fletcher, J Wesley; Ramamurthi, Arathi; Parekh, Palak

    2016-04-01

    Epidermolytic hyperkeratosis is a histological reaction pattern seen in a variety of disease processes, including epidermolytic ichthyosis, Vorner's epidermolytic palmoplantar keratoderma, epidermal nevus, and solitary epidermolytic acanthoma. Here we present the case of a 59-year-old woman with multiple asymptomatic papules on her vulva. Clinical differential diagnoses included condyloma acuminata, seborrheic keratoses, bowenoid papulosis, adnexal tumors, and papular acantholytic dyskeratosis. Shave biopsy revealed findings consistent with epidermolytic hyperkeratosis. This case represents an interesting presentation of focally disseminated vulvar epidermolytic acanthomas and highlights the importance of a biopsy in establishing this diagnosis. PMID:27034569

  17. Extension of extramammary Paget disease of the vulva to the cervix.

    PubMed Central

    Lloyd, J; Evans, D J; Flanagan, A M

    1999-01-01

    Extramammary Paget disease of the vulva was found in association with vulval adenocarcinoma in an elderly woman who also had a uterine prolapse. The characteristic histological appearances of extramammary Paget disease were masked by striking reactive changes in the squamous epithelium. Primary excision of both the intraepithelial and invasive disease appeared complete. However, a subsequent hysterectomy with repair of the prolapse revealed extramammary Paget disease in the upper vaginal mucosa and cervix, a finding which is very rarely described. Pathogenesis and diagnosis of extramammary Paget disease is discussed, with differential diagnosis and reference to immunohistochemical methods. Images PMID:10605411

  18. Verruca vulgaris of the vulva in children and adults: a nonvenereal type of vulvar wart.

    PubMed

    Aguilera-Barrantes, Irene; Magro, Cynthia; Nuovo, Gerard J

    2007-04-01

    Condyloma acuminata are common lesions of the vulva in adults, and associated with infection by human papillomavirus (HPV) types 6 and 11, which are acquired via sexual contact. The detection of an HPV 6/11 condyloma in the genital tract of a child, therefore, raises the question of sexual abuse. In this study, 29 genital warts in girls less than 5 years of age were examined for nongenital and genital tract HPVs by in situ hybridization. These results were compared with 275 vulvar lesions clinically suspicious for condyloma from adults. Of the 27 HPV-related lesions in young girls, 11 (41%) were due to HPV 2 whereas the other 16 (59%) were associated with HPV 6/11 infection. Of the 214/275 (78%) HPV positive vulvar lesions in adults, 6 (3%) were due to HPV 2 whereas 202/214 (94%) contained HPVs 6/11; 1 lesion contained HPV 16 and the 5 other lesions contained HPV 42, 43, or 44. Histologic correlation documented that the vulvar lesions positive for HPV 2 commonly showed the marked hyperkeratosis typical of verruca vulgaris. However, the verrucous pattern was present in lesions HPV 6/11 positive. It is concluded that verruca vulgaris of the vulva, which is likely not transmitted sexually, can occur, albeit rarely, in the genital tract of women and is common in the genital tracts of young girls. This highlights the value of HPV testing in such cases, especially if the histologic changes are consistent with verruca vulgaris. PMID:17414099

  19. Crusted scabies misdiagnosed as erythrodermic psoriasis in a 3-year-old girl with down syndrome.

    PubMed

    Fonseca, Vanessa; Price, Harper N; Jeffries, Michelle; Alder, Steven L; Hansen, Ronald C

    2014-01-01

    Scabies is a highly contagious infestation with the Sarcoptes scabiei var hominis mite. The variety of clinical presentations make timely, accurate diagnosis problematic. We report the case of a 3-year-old girl with Down syndrome and crusted scabies initially misdiagnosed as erythrodermic psoriasis. PMID:24138478

  20. Aneurysmal Bone Cyst of Sphenoid Bone and Clivus Misdiagnosed as Chordoma: A Case Report

    PubMed Central

    Samanci, Cesur; Asik, Murat; Yanik, Inanc; Ozkanli, Seyma; Tutar, Onur; Hasiloglu, Zehra Isik

    2015-01-01

    Aneurysmal bone cysts (ABCs) are benign and rapidly expanding bone destructive lesions of any bone. They are commonly localized in the metaphysis of long bones, whereas skull base ABCs are rare. We report a case of a 21-year-old man who had been misdiagnosed as chordoma and undergone surgery. However, histopathological examination revealed it to be an ABC. PMID:26605267

  1. Benign Phyllodes Tumor of the Vulva: A Case Report and Literature Review

    PubMed Central

    Denlinger, LeAnn N.; Lokhandwala, Parvez M.

    2015-01-01

    Phyllodes tumor is an uncommon breast lesion with characteristic histologic appearance when examined by hematoxylin and eosin staining: leaf-like fronds projecting into cystic spaces on low-power microscopy, and biphasic (epithelial and stromal) components on high-power microscopy. We report a rare primary case of this tumor arising within the vulva. A 34-year old African American female presented with a 3 cm slow-growing vulvar mass initially thought to be an inclusion cyst. The lesion was excised and histologic examination demonstrated this lesion to be a rare case of benign phyllodes tumor with morphologic features similar to those arising from breast tissue. Patient received no further treatment and did not exhibit any recurrence or metastasis. Nearly two years after excision, the patient died due to an unrelated medical cause. This rare tumor should be considered in the differential diagnosis for women presenting with a slow-growing vulvar mass. PMID:26788277

  2. Multiple granular cell tumors with metachronous occurrence in tongue and vulva. Clinicopathological and immunohistochemical study.

    PubMed

    Vera-Sirera, Beatriz; Zabala, Pablo; Aviño-Mira, Carlos; Vera-Sempere, Francisco J

    2014-01-01

    Granular cell tumor (GCT) usually occurs as a single tumor, although sometimes multiple lesions can occur. In present report we analyze the clinicopathological and immunohistochemical features of a multiple GCT involving the tongue of a 14-year-old girl, with no other abnormalities, with a metachronous occurrence of a second GCT in vulva, after a period of 10 years. Both tumors revealed S-100, vimentin and CD57 positivity. In addition, over expression of calretinin was observed in tumor cells located in the vicinity of pseudoepitheliomatous hyperplasia (PEH) of the tongue. Tumor vasculature situated close to the PEH showed marked CD105 reactivity, data not described so far, suggesting an interaction between PEH cells and underlying stroma, since GCT completely lacks CD105 vessels. Our study emphasizes that patients with GCT, especially young patients, should be followed long-term, looking for multiple tumors or other abnormalities suggestive of a systemic syndrome, given the associations described in multiple GCT. PMID:25949003

  3. Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva

    PubMed Central

    GAUDINEAU, A.; WEITBRUCH, D.; QUETIN, P.; HEYMANN, S.; PETIT, T.; VOLKMAR, P.; BODIN, F.; VELTEN, M.; RODIER, J.F.

    2012-01-01

    Alternative therapies have been sought to alleviate mutilation and morbidity associated with surgery for vulvar neoplasms. Our prime objective was to assess tumor absence in pathological vulvar and nodal specimens following neoadjuvant chemoradiotherapy in locally advanced vulvar neoplasms. Data were retrospectively collected from January 2001 to May 2009 from 22 patients treated with neoadjuvant therapy for locally advanced squamous cell carcinoma of the vulva. Neoadjuvant treatment consisted of inguino-pelvic radiotherapy (50 Gy) in association with chemotherapy when possible. Surgery occurred at intervals of between 5 to 8 weeks. The median age of patients at diagnosis was 74.1 years. All patients were primarily treated with radiotherapy and 15 received a concomitant chemotherapy. Additionally, all patients underwent radical vulvectomy and bilateral inguino-femoral lymphadenectomy. Tumor absence in the vulvar and nodal pathological specimens was achieved for 6 (27%) patients, while absence in the vulvar pathological specimens was only achieved for 10 (45.4%) patients. Postoperative follow-up revealed breakdown of groin wounds, vulvar wounds and chronic lymphedema in 3 (14.3%), 7 (31.8%) and 14 cases (63.6%), respectively. Within a median follow-up time of 2.3 years [interquartile range (IQR), 0.6–4.6], 12 (54.6%) patients experienced complete remission and 6 cases succumbed to metastatic evolution within a median of 2.2 years (IQR, 0.6–4.6), with 1 case also experiencing perineal recurrence. Median survival time, estimated using the Kaplan-Meier method, was 5.1 years (IQR, 1.0–6.8). We suggest that neoadjuvant chemoradiotherapy may represent a reliable and promising strategy in locally advanced squamous cell carcinoma of the vulva. PMID:23205089

  4. Splenic abscess due to chronic melioidosis in a patient previously misdiagnosed as tuberculosis

    PubMed Central

    Kunnathuparambil, Sojan George; Sathar, Shanid Abdul; Tank, Devang Chandrakanth; Sreesh, Srijaya; Mukunda, Madhav; Narayanan, Premaletha; Vinayakumar, Kattoor Ramakrishnan

    2013-01-01

    Melioidosis is endemic in Southeast Asia and Northern Australia. Sporadic cases have been reported from many parts of the world where it has an epidemic potential with high-rate fatality cases. In non-endemic areas, melioidosis may be misdiagnosed with common diseases and this may prove fatal. Sporadic cases of melioidosis are mistaken for tuberculosis in India. We report a case of splenic abscess due to chronic melioidosis who was earlier misdiagnosed as tuberculosis and underwent anti-tuberculosis therapy. Following treatment of melioidosis his symptoms subsided. This case is reported because of the rarity of the disease and to highlight the importance of looking for melioidosis in patients with splenic abscess even in non-endemic areas. PMID:24714690

  5. Renal Endometriosis Tends to Be Misdiagnosed as Renal Tumor: A Rare Case Report

    PubMed Central

    Yang, Jie; Song, Ri-jin; Xu, Chen; Zhang, Shi-qing; Zhang, Wei

    2015-01-01

    Renal endometriosis is a rare disease for which the mechanisms of pathogenesis are still unclear. As such, early diagnosis and an appropriate treatment are often delayed because of the tendency to be misdiagnosed as a renal tumor. In October 2013 we performed a radical nephrectomy for a 37-year-old woman with renal endometriosis who was preoperatively misdiagnosed as having a right renal tumor. Avoiding the misdiagnosis of renal endometriosis requires a detailed case history, especially regarding whether the cyclicity of lumbodorsal pain and hematuria correlates with patients' menstrual cycles. Imaging examinations are commonly helpful for localization, whereas relieving symptoms with drugs to create a hypoestrogenic state is useful for clinical diagnosis. However, a final diagnosis for renal endometriosis still must depend on histopathologic examination. PMID:25692445

  6. Successful Treatment of Congenital Lymphangioma Circumscriptum of the Vulva with CO2 and Long-Pulsed Nd:YAG Lasers

    PubMed Central

    Sasaki, Ryosuke; Negishi, Kei; Akita, Hirotaka; Suzuki, Kayoko; Matsunaga, Kayoko

    2014-01-01

    A 16-year-old girl presented with a 9-year history of vesicles on the vulva. She had initially taken a wait-and-see approach, but required treatment because of bleeding. Histological examination of a biopsied vesicle revealed dilated lymph channels in the upper dermis, suggesting lymphangioma circumscriptum (LC). The challenge for this pathology has been to find a conservative treatment with low morbidity and better results than those reported for surgical excision, which has been the mainstay of therapy. In this case, LC of the vulva was successfully treated using a 10,600-nm CO2 laser and long-pulsed Nd:YAG laser. Use of the 10,600-nm CO2 laser and long-pulsed Nd:YAG laser appeared effective for treating LC. PMID:24575003

  7. Metastatic adenocarcinoma of mammary-like glands of the vulva successfully treated with surgery and hormonal therapy.

    PubMed

    Benito, Virginia; Arribas, Sara; Martnez, David; Medina, Norberto; Lubrano, Amina; Arencibia, Octavio

    2013-01-01

    Vulvar cancer is a rare malignancy; most tumors are squamous cell type while adenocarcinomas are rare. Primary adenocarcinomas of the vulva predominantly include extramammary Paget's disease and sweat gland carcinomas. Greene first described a rare form of adenocarcinoma in 1936, which was called adenocarcinoma of mammary-like glands of the vulva because of its morphologic and immunohistochemical resemblance to breast adenocarcinomas. In the management of this entity, varying combinations of surgery, radiation therapy, systemic chemotherapy and/or hormonal therapy may be used, as in patients with orthotopic breast carcinoma. However, hormonal therapy leads the way in patients with positive hormonal receptors, where other therapies cannot be used due to comorbidities or advanced age. We present the first reported case of an elderly patient with metastatic vulvar adenocarcinoma arising from mammary-like glands, successfully treated with a combination of surgery and hormonal therapy. PMID:22764738

  8. [HPV-associated alterations of the vulva and vagina. Morphology and molecular pathology].

    PubMed

    Horn, L-C; Klostermann, K; Hautmann, S; Höhn, A K; Beckmann, M W; Mehlhorn, G

    2011-11-01

    Non-neoplastic HPV-induced alterations of the vulva and vagina are frequent. The traditional three-tier grading system of vulvar intraepithelial neoplasia (VIN) will be replaced by the definition of usual and simplex type of VIN. The usual type is characterized by a strong association to high-risk HPV infections, the occurrence at younger age and multifocality, mostly associated with non-keratinizing squamous cell carcinoma. The differentiated (or simplex) type is rare and shows an association to older age and p53 alterations and is typically diagnosed co-incidentally with keratinizing squamous cell carcinoma. Vaginal intraepithelial neoplasia (VAIN) is still graded into VAIN 1-3 where VAIN 1 and 2 are mostly associated with low-risk HPV infections and a high spontaneous regression rate whereas VAIN 3 represents a high-risk HPV-associated lesion with capable progression into (micro-)invasive carcinoma. The differential diagnosis between a non-neoplastic condylomatous lesion and VIN common type and VAIN may be aided by p16 immunohistochemistry. The HPV-associated invasive vulvo-vaginal cancers are verrucous carcinoma (low-risk HPV) and the high-risk HPV-induced (non-keratinizing) squamous cell carcinoma (NOS), the condylomatous (warty) carcinoma and the very rare vaginal squamo-transitional carcinoma. PMID:22038133

  9. Spontaneous Coronary Artery Dissection Misdiagnosed as Takotsubo Cardiomyopathy: A Case Series.

    PubMed

    Chou, Annie Y; Sedlak, Tara; Aymong, Eve; Sheth, Tej; Starovoytov, Andrew; Humphries, Karin H; Mancini, G B John; Saw, Jacqueline

    2015-08-01

    Spontaneous coronary artery dissection (SCAD) and Takotsubo cardiomyopathy (TTC) can both cause myocardial infarction with subsequent normalization of wall motion abnormality. Angiograms of patients with TTC at Vancouver General Hospital were reviewed for SCAD. Clinical and investigational characteristics were recorded. Nine women with nonatherosclerotic SCAD were misdiagnosed as having TTC. Their average age was 55 years. Five patients had hypertension and 4 had emotional or physical stress. Fibromuscular dysplasia was present in 4 women. Wall motion abnormalities corresponded to dissected artery location and subsequently resolved. SCAD should be included in the differential diagnosis of patients suspected of having TTC and coronary angiograms scrutinized for subtle SCAD. PMID:26211710

  10. Caroli's disease misdiagnosed as intraductal papillary neoplasm of the bile duct.

    PubMed

    Gu, Dae Hoe; Park, Min Seon; Jung, Chang Ho; Yoo, Yang Jae; Cho, Jae Young; Lee, Yun Ho; Seo, Yeon Seok; Yim, Hyung Joon; Um, Soon Ho; Ryu, Ho Sang

    2015-06-01

    Caroli's disease is a rare autosomal-recessive disorder caused by malformation of the ductal plate during embryonic development. Although it is present at birth, Caroli's disease is typically not diagnosed until between the second and fourth decades of life, as it was in the present patient. Here we report a rare case of Caroli's disease limited to one liver segment, which was initially misdiagnosed as an intraductal papillary neoplasm of the bile duct. The asymptomatic patient was treated with liver segmentectomy. PMID:26157755

  11. Caroli's disease misdiagnosed as intraductal papillary neoplasm of the bile duct

    PubMed Central

    Gu, Dae Hoe; Park, Min Seon; Jung, Chang Ho; Yoo, Yang Jae; Cho, Jae Young; Lee, Yun Ho; Yim, Hyung Joon; Um, Soon Ho; Ryu, Ho Sang

    2015-01-01

    Caroli's disease is a rare autosomal-recessive disorder caused by malformation of the ductal plate during embryonic development. Although it is present at birth, Caroli's disease is typically not diagnosed until between the second and fourth decades of life, as it was in the present patient. Here we report a rare case of Caroli's disease limited to one liver segment, which was initially misdiagnosed as an intraductal papillary neoplasm of the bile duct. The asymptomatic patient was treated with liver segmentectomy. PMID:26157755

  12. Case of mature cystic teratoma of the greater omentum misdiagnosed as ovarian cyst.

    PubMed

    Yoshida, Atsushi; Murabayashi, Nao; Shiozaki, Takaya; Okugawa, Toshiharu; Tabata, Tsutomu

    2005-10-01

    The teratoma of the greater omentum is a very rare entity. We present a case of mature cystic teratoma of the greater omentum misdiagnosed as ovarian cyst. The patient was a 36-year-old woman with an omental teratoma of 5 x 4 x 4 cm and an atrophic left ovary. The histopathologic diagnosis was mature cystic teratoma of the greater omentum and no evidence of immaturity or malignancy was noted. Preoperative tumor marker tests revealed moderate elevation of cancer antigen (CA)125, CA19-9 and carcinoembryonic antigen. The left ovary of the patient was atrophic and possible autoamputation of the ovarian tissue might be suggested. PMID:16176507

  13. Acral lentiginous melanoma of the foot misdiagnosed as a traumatic ulcer. A cautionary case.

    PubMed

    Gumaste, Priyanka; Penn, Lauren; Cohen, Nicole; Berman, Russell; Pavlick, Anna; Polsky, David

    2015-03-01

    The incidence of cutaneous melanoma is rising faster than that of almost any other cancer in the United States. Acral lentiginous melanoma is a subtype of melanoma that involves the palms, soles, and nail beds. Although it is one of the rarer types of melanoma, it has a poorer prognosis than other more common subtypes. We describe a case of plantar acral melanoma in a 66-year-old woman that was initially misdiagnosed as a traumatic foot ulcer. We highlight this case to emphasize the importance of close observation and biopsy of ulcerative lesions of the foot that have atypical features or are refractory to standard treatment. PMID:25815661

  14. A rare case of adult hepatoblastoma with neuroendocrine differentiation misdiagnosed as neuroendocrine tumor.

    PubMed

    Zhang, Qingfu; Ming, Jian; Zhang, Siyang; Guo, Dawei; Qiu, Xueshan

    2013-01-01

    Hepatoblastoma is the most common malignant liver tumor between the age of 6 months and 3 years, but it is extremely rare in adults. Only Forty-five cases of adult hepatoblastoma were reported up to now in the world. Hepatoblastoma exhibits a wide range of epithelial and mesenchymal lines differentiation, but neuroendocrine differentiation of this tumor has rare been reported in the literature. Here, we reported a case of primary giant hepatoblastoma (about 11.4*7.9*15.3 cm) with neuroendocrine differentiation of a 32-year-old woman, which was misdiagnosed as neuroendocrine tumor. PMID:23330017

  15. Pre-operatively misdiagnosed undifferentiated embryonal sarcoma of the liver: analysis of 16 cases

    PubMed Central

    Li, Yanzhuo; Cai, Quanyu; Jia, Ningyang; Chen, Dong; Lu, Lun

    2015-01-01

    Background To investigate the clinical features of undifferentiated embryonal sarcoma of the liver (UESL) to improve its preoperative diagnostic accuracy. Methods The clinical, imaging, and histopathologic findings of 16 UESL patients whose disease was pathologically confirmed but preoperatively misdiagnosed were retrospectively analyzed. Results Among these 16 patients, 9 were clinically misdiagnosed as primary liver cancer, 3 as hepatoblastoma, and 4 as malignant hepatic mass. In 12 patients who were presented due to abdominal discomfort, ultrasound showed that predominantly solid lesions, whereas computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated predominantly cystic masses within irregular soft tissue. Contrast-enhanced imaging showed enhancement intralesional foci, multiple internal septations, and edges. The postoperative pathology showed the cutting surface of tumors was variegated, with solid and cystic gelatinous areas, hemorrhage, and necrosis. Intracytoplasmic hyaline globules were commonly present among cancer cells. Conclusions UESL is a rare clinical condition without specific clinical manifestations. The inconsistencies between ultrasound and CT/MRI findings may be helpful to improve the preoperative diagnosis accuracy. PMID:26807408

  16. Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations

    PubMed Central

    Ventolini, Gary; Patel, Ravi; Vasquez, Robert

    2015-01-01

    Objective Lichen sclerosus (LS) is a chronic progressive inflammatory autoimmune-induced disease that primarily affects the epidermis and dermis of the external genital-anal region. Intense and recalcitrant pruritus is the hallmark of LS. Physical exam reveals thinning, hyperkeratosis, and parchment-like appearance. However, the classic symptom and signs of LS may not always be present and patients may be asymptomatic for pruritus. Hence, we describe 15 misdiagnosed cases with atypical clinical presentations. We believe that the absence of pruritus contributed to their initial misdiagnosis. The purpose of this paper is to increase awareness of atypical presentations of LS. Methods Data base review of de-identified clinical case pictures was performed. All patients had histopathology-confirmed diagnoses of LS. The data base file contains 800 cases of vulvovaginal disorders. The Institutional Review Board (IRB) considered that searching a de-identified data base of pictures did not require IRB approval. Results We identified 15 different atypical clinical cases. Patient ages were 18–75 years old. These patients were asymptomatic for pruritus and were misdiagnosed before they presented to the vulvovaginal specialized clinic. Conclusion Fifteen patients asymptomatic for pruritus with histopathology-confirmed diagnosis of LS were identified. They illustrate atypical clinical presentations that LS may have. PMID:26056492

  17. Oncogenic viruses associated with vulva cancer in HIV-1 patients in Botswana

    PubMed Central

    2014-01-01

    Background Oncoviruses such as HPV, KSHV, and EBV have been reported in patients with HIV infection and AIDS. How oncovirus-associated cancers rise in AIDS patients has not been fully established. The purpose of our study was to identify the viral agents in vulvar cancer and to assess their contribution to pathogenesis. Method We retrospectively identified a total of 13 vulva tissue samples from HIV-1 positive and 9 vulvar samples from HIV-1 negative patients from the Botswana National Health Laboratory in Gaborone, Botswana, a Southern African country with a high incidence of HIV. We utilized PCR and IHC to identify HPV, EBV, KSHV, and JC virus in FFPE preserved tissue samples. Results Using the GP5+/GP6+ primer set we detected several HPV types in tissue samples. EBV was detected in all of the positive cases (100%) and in most of the negative cases (89%). KSHV was detected in 39% of the HIV-1 positive samples and in 11% of the negative samples, and no JC virus was detected in any of the samples. Using IHC we demonstrated that LANA was expressed in 61% of the positive samples and in 44% of the negative samples. The ubiquitous EBV was more consistently expressed in negative cases (100%) than in positive cases (69%). Interestingly, the HPV-16 E6 transcript was detected in 56% of the negative samples compared to 31% of the positive samples. However, the cell cycle protein P21 used as a surrogate marker for HPV was detected in 77% of the positive samples and in 44% of the negative samples, while VEGF signals were similar in both positive (92%) and negative samples (89%). Conclusion Our study, suggests that in Botswana, vulvar squamous cell carcinoma (VSCC) is associated with oncogenic viruses present in the niche but the contribution and progression may be regulated by HPV and other immunosuppressive infections that include HIV-1. PMID:25225572

  18. Transvaginal Resection of a Bladder Leiomyoma Misdiagnosed with a Vaginal Mass: A Case Report and Literature Review

    PubMed Central

    Yin, Fu-Fen; Wang, Ning; Wang, You-Lin; Bi, Xiao-Ning; Xu, Xiao-Hui; Wang, Yan-Kui

    2015-01-01

    Bladder leiomyoma is a rare benign tumor and it could be easily misdiagnosed with many other pelvic diseases, especially obstetrical and gynecological diseases; abdominal, laparoscopic, and transurethral resection of bladder leiomyoma have been reported. Herein, we present a case of bladder leiomyoma misdiagnosed with a vaginal mass preoperatively; the mass was isolated, enucleated from the bladder neck, and removed transvaginally; to the best of our knowledge, this is the first case of intramural leiomyoma of bladder neck that has been enucleated transvaginally only without cystotomy. PMID:26693368

  19. Caenorhabditis elegans syndecan (SDN-1) is required for normal egg laying and associates with the nervous system and the vulva.

    PubMed

    Minniti, Alicia N; Labarca, Mariana; Hurtado, Claudia; Brandan, Enrique

    2004-10-01

    In Caenorhabditis elegans, the identification of many enzymes involved in the synthesis and modification of glycosaminoglycans (GAGs), essential components of proteoglycans, has attained special attention in recent years. Mutations in all the genes that encode for GAG biosynthetic enzymes show defects in the development of the vulva, specifically in the invagination of the vulval epithelium. Mutants for certain heparan sulfate modifying enzymes present axonal and cellular guidance defects in specific neuronal classes. Although most of the enzymes involved in the biosynthesis and modification of heparan sulfate have been characterized in C. elegans, little is known regarding the core proteins to which these GAGs covalently bind in proteoglycans. A single syndecan homologue (sdn-1) has been identified in the C. elegans genome through sequence analysis. In the present study, we show that C. elegans synthesizes sulfated proteoglycans, seen as three distinct species in western blot analysis. In the sdn-1 (ok449) deletion mutant allele we observed the lack of one species, which corresponds to a 50 kDa product after heparitinase treatment. The expression of sdn-1 mRNA and sequencing revealed that sdn-1 (ok449) deletion mutants lack two glycosylation sites. Hence, the missing protein in the western blot analysis probably corresponds to SDN-1. In addition, we show that SDN-1 localizes to the C. elegans nerve ring, nerve cords and to the vulva. SDN-1 is found specifically phosphorylated in nerve ring neurons and in the vulva, in both wild-type worms and sdn-1 (ok449) deletion mutants. These mutants show a defective egg-laying phenotype. Our results show for the first time, the identification, localization and some functional aspects of syndecan in the nematode C. elegans. PMID:15456854

  20. Clinical Manifestations and Therapeutic Management of Vulvar Cellulitis and Abscess: Methicillin-resistant Staphylococcus aureus, Necrotizing Fasciitis, Bartholin Abscess, Crohn Disease of the Vulva, Hidradenitis Suppurativa.

    PubMed

    Wood, Sara C

    2015-09-01

    Infections of the vulva can present a complex differential to the gynecologist, ranging from superficial skin infections to life-threatening necrotizing fasciitis. Recognition and timely treatment remain universal to skin and soft-tissue infections as the subcutaneous anatomy of the vulva can facilitate rapid spread to other tissues with significant morbidity and mortality. Ineffective antibiotics or deferring necessary surgical debridement have proven to be costly to the patient, and the gynecologist must maintain an appropriately high index of suspicion. Employing a multidisciplinary team approach to care for vulvar cellulitis can guide treatment from antibiotic therapies to more aggressive surgical debridement. PMID:26125959

  1. Wernicke's encephalopathy after laparoscopic Roux-en-Y gastric bypass: a misdiagnosed complication.

    PubMed

    Iannelli, Antonio; Addeo, Pietro; Novellas, Sebastien; Gugenheim, Jean

    2010-11-01

    Malabsorptive syndromes and micronutrient deficiencies represent well-known long-term complications of bariatric surgery. Wernicke's encephalopathy (WE), a neurologic manifestation of thiamine deficiency, has been classically associated with alcoholism or severe malnutrition, but rarely reported after bariatric surgery. Herein, we describe the case of a 27-year-old woman that developed WE 10 months after laparoscopic Roux-en-Y gastric bypass for morbid obesity that was initially misdiagnosed with a consequent retard in the appropriate treatment. Although only a few sporadic cases have been reported in the literature, all surgeons and physicians involved in the care of bariatric patients must be aware of this potentially serious complication. PMID:20195787

  2. Thrombolytic-related complication in a case of misdiagnosed myocardial infarction.

    PubMed

    Irivbogbe, Osereme; Mirrer, Brooks; Loarte, Pablo; Gale, Michael; Cohen, Ronny

    2014-06-01

    The importance of early thrombolysis in acute myocardial infarction has been highlighted in several large trials. The clinical decision is often taken by physicians who need to take a rapid action with the risk of misdiagnosing non-coronary events that mimic myocardial infarction. Here we describe a case of acute pericarditis in a 37-year-old man whom received thrombolysis and developed a sudden hemorrhagic pericardial effusion that evolved rapidly into a cardiac tamponade. These errors leading to lethal thrombolysis complications have been surprisingly rare; but a correct diagnosis of aortic dissection or hemorrhagic pericarditis needs to be stressed because even after obtaining the correct diagnosis, the prolonged disturbance of hemostasis prevents a rapid therapy being instigated. PMID:24749992

  3. Infantile osteoarticular tuberculosis misdiagnosed as Bacillus Calmette-Guerin related osteomyelitis

    PubMed Central

    Limpaphayom, Noppachart; Osateerakun, Phatcharapa; Theamboonlers, Apiradee; Korkong, Sumeth; Poovorawan, Yong

    2015-01-01

    Tuberculosis, a re-emerging public health problem, is uncommon in infancy. Two healthy completely immunized infants presenting with manifestations compatible with osteoarticular infection required surgical debridement. The cultures of the specimens were positive for M. tuberculosis (MTB) complex comprised multiple subspecies. One case was misdiagnosed as a Bacillus Calmette-Guerin (BCG) related osteomyelitis by a polymerase chain reaction (PCR) based on detection of genes at the region of difference 1. Genome extraction and PCR using the rimM gene and sequences analysis against MTB and BCG control samples confirmed that both specimens were infected by M. tuberculosis. The lesions were successfully healed within one year. Surgical debridement of suspected lesions is warranted in infants as a definitive treatment and to obtain tissues for further evaluation. Microbiological cultures only confirm nonspecific MTB complex infection. PCR kits may yield a false positive result. Identification of the pathogen by DNA extraction and sequence analysis should be recommended.

  4. Efficacy of inosine pranobex oral therapy in subclinical human papillomavirus infection of the vulva: a randomized double-blinded placebo controlled study.

    PubMed

    Tay, S K

    1996-07-01

    A randomized double-blind placebo controlled study was carried out to assess the efficacy of inosine pranobex (1 g orally 3 times a day for 6 weeks) in the treatment of symptomatic subclinical human papillomavirus infection of the vulva. In a series of 55 women, 22 patients in the inosine pranobex group and 24 patients in the placebo group were suitable for analysis. A total of 14 (63.5%) of the inosine pranobex treated patients and 4 (16.7%) of the placebo treated patients showed significant vulval epithelial morphological improvement (P = 0.005) at 2 months after initiation of treatment. Whereas 13 (59.1%) and 9 (37.5%) patients in the respective groups showed significant improvement in the severity of pruritus vulvae (P = 0.435). Twelve (66.7%) of 18 patients with morphological improvement compared to 10 (35.7%) of 28 patients with no morphological improvement experienced significant symptomatic alleviation of pruritus vulvae (P = 0.041). Similar results were seen at the second assessment 4 months after the initiation of treatment. Adverse drug reactions were reported by 2 patients in the treatment group and by 2 patients (skin rash) in the placebo group. These adverse reactions were mild and self limiting. It is concluded that inosine pranobex demonstrated a significant pharmacological activity in subclinical HPV infection of the vulva and should be considered an alternative treatment for the condition. PMID:8876359

  5. Metastatic Uterine Leiomyosarcoma in the Upper Buccal Gingiva Misdiagnosed as an Epulis

    PubMed Central

    Cassoni, Andrea; Terenzi, Valentina; Bartoli, Davina; Zadeh, Oriana Rajabtork; Battisti, Andrea; Pagnoni, Mario; Conte, Davide; Lembo, Alessandro; Bosco, Sandro; Alesini, Francesco; Valentini, Valentino

    2014-01-01

    Uterine leiomyosarcoma (LMS) is a rare tumor constituting 1% of all uterine malignancies. This sarcoma demonstrates an aggressive growth pattern with an high rate of recurrence with hematologic dissemination; the most common sites are lung, liver, and peritoneal cavity, head and neck district being rarely interested. Only other four cases of metastasis in the oral cavity have been previously described. The treatment of choice is surgery and the use of adjuvant chemotherapy and radiation has limited impact on clinical outcome. In case of metastases, surgical excision can be performed considering extent of disease, number and type of distant lesions, disease free interval from the initial diagnosis to the time of metastases, and expected life span. We illustrate a case of uterine LMS metastasis in the upper buccal gingiva that occurred during chemotherapy in a 63-year-old woman that underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a diagnosis of LMS staged as pT2bN0 and that developed lung metastases eight months after primary treatment. Surgical excision of the oral mass (previously misdiagnosed as epulis at a dental center) and contemporary reconstruction with pedicled temporalis muscle flap was performed in order to improve quality of life. Even if resection was achieved in free margins, “local” relapse was observed 5 months after surgery. PMID:25386373

  6. Lymphomatoid papulosis misdiagnosed as pityriasis lichenoides et varioliformis acuta: Two case reports and a literature review

    PubMed Central

    ZHENG, YAN; JIA, JINJING; TIAN, QIONG; DONG, XINYU; WANG, XIN; YING, ZHAOXIA; XIAO, SHENGXIANG; LI, WENSHENG

    2014-01-01

    The aim of this study was to improve the level of diagnosis and differential diagnosis of lymphomatoid papulosis (LyP). Two cases of type B LyP were identified and the literature was reviewed to summarize the clinical outcomes and pathology of LyP and its treatment. The two patients exhibited symptoms with papulonodular lesions, the centers of which gradually underwent ulceration and necrosis. CD30, a helper T-cell marker specifically expressed in tumor cells was analyzed by immunohistochemical staining and the result showed that CD30-negative or only scattered CD30-positive cells were present. Therefore, a diagnosis of type B LyP was made. A fairly good curative effect was achieved following treatment with retinoic acid, glucocorticoids and immunomodulatory drugs. LyP is a type of low-level malignant lymphoma and is easily misdiagnosed as pityriasis lichenoides et varioliformis acuta and other diseases. In order to avoid under diagnosis and misdiagnosis, doctors should evaluate suspected patients by histopathological and immunohistochemical examination. PMID:25371758

  7. Improving the management of imported schistosomiasis haematobia in China: lessons from a case with multiple misdiagnoses

    PubMed Central

    2013-01-01

    Background Human Schistosoma haematobium infection that causes urinary schistosomiasis occurs in Africa and the eastern Mediterranean, and China is only endemic for S. japonicum. In this report, we reported an imported case with S. haematobium infection returning from Angola to Shaanxi Province, northwestern China, where S. japonicum is not endemic. Findings The case was misdiagnosed as ureteral calculus, invasive urothelial carcinoma and eosinophilic cystitis in several hospitals, and was finally diagnosed by means of serological assay followed by microscopic examination of the urine sediment. The patient was then treated with praziquantel, and a satisfactory outcome was obtained. Conclusions As S. haematobium is not indigenous to China, most Chinese doctors and medical technicians are unfamiliar with this introduced parasitic disease, therefore, they need to increase the awareness of its existence when they encounter persons who have visited or resided in endemic areas, and the techniques for detection of the parasite, so as to reduce the misdiagnosis. In addition, health education should be given to those who will go to the endemic areas to improve their knowledge and awareness on prevention and control of schistosomiasis haematobia, thereby reducing the risk of exposure to the infested freshwater. PMID:24020375

  8. A case of diffuse large B-cell lymphoma misdiagnosed as an erysipelas of the face.

    PubMed

    Teresiak-Mikołajczak, Ewa; Szymańska, Magdalena; Czarnecka-Operacz, Magdalena

    2013-08-01

    We report a case of a woman with diffuse large B-cell lymphoma (DLBCL). Primary cutaneous lymphomas (PCLs) represent distinct clinical and histopathologic subtypes of extranodal T- and B-cell lymphomas. Cutaneous B-cell lymphomas comprise 20-25% of all primary cutaneous lymphomas. The patient presented an erythematous tumour mass of the left nasolabial fold, nose and left cheek as well as disseminated infiltrative plagues on the trunk, arms and left lower leg. Skin biopsy revealed a diffuse infiltrate of lymphocytes around hair follicles and blood vessels within dermis and subcutaneous tissue. An immunohistochemistry showed a diffuse infiltrate of large non-cleaved B-cells, with a high proportion of centroblast-like cells within dermis. Tumor cells expressed CD20, bcl-2 protein and did not express CD10. The patient was misdiagnosed as the erysipelas of the face and unsuccessfully treated with long-term antibiotic therapy by a laryngologist and a dermatologist. The correct diagnosis was delayed and established after 6 months' history of DLBCL lesions. Therefore, we would like to strongly stress the importance of considering diagnosis of cutaneous lymphomas in chronic skin lesions non-responsive to adequate therapies. PMID:24278087

  9. Uterine leiomyoma associated non-puerperal uterine inversion misdiagnosed as advanced cervical cancer: A case report☆

    PubMed Central

    Umeononihu, Osita Samuel; Adinma, Joseph Ifeanyi; Obiechina, Nworah J.; Eleje, George Uchenna; udegbunam, Onyebuchi Izuchukwu; Mbachu, Ikechukwu Innocent

    2013-01-01

    INTRODUCTION Uterine inversion is an un-common complication of parturition which often occurs in the immediate postpartum period. The chronic (non-puerperal) uterine inversion is rarer and most times tumour associated. PRESENTATION OF CASE A 51-year old grand multiparous lady presented with a month history of abnormal vaginal bleeding associated with offensive vaginal discharge, lower abdominal pain and dizziness. The initial evaluation suggested severe anaemia secondary to advanced cervical cancer. Examination under anaesthesia (EUA), staging and biopsy was attempted but this was however inconclusive due to profuse haemorrhage. A repeat EUA revealed chronic uterine inversion secondary to fundal submucous uterine leiomyoma. Myomectomy was done with tissue histology confirming benign uterine leiomyoma. Two weeks later, a modified Haultain's procedure was done followed by simple hysterectomy and posterior colpoperineorrhaphy. She had satisfactory recovery. DISCUSSION This is the first reported case of chronic non-puerperal uterine inversion in our hospital. When it occurs, it is usually tumour associated with the commonest tumour being prolapsed myoma and leiomyosarcoma. The diagnosis is based on high index of suspicion. CONCLUSION Chronic uterine inversion is a rare gynaecological condition and can be misdiagnosed as advanced cervical cancer or other causes of severe genital haemorrhage in women. A high index of suspicion is needed for its proper diagnosis. Sometimes, an EUA and biopsy was required to determine the cause here and conveniently it could be described as a “gynaecolological near miss”. PMID:24091076

  10. Fetal t(5p;21q) misdiagnosed as monosomy 21: A plea for in situ hybridization studies

    SciTech Connect

    Gill, P.; Uhrich, S.; Cheng, E.; Disteche, C.

    1994-10-01

    We report a case of 45,XY,-5,-21,+der (5)t(5;21) (p13 or p14;q11.2 or q21) that was prenatally misdiagnosed as complete monosomy 21 and terminated at 24 weeks of gestation. Subsequent fluorescence in situ hybridization studies with a chromosome 21 painting probe documented the cryptic unbalanced translocation. 17 refs., 2 figs., 1 tab.

  11. Family history unawareness of blood clot risk: links to misdiagnoses and illness uncertainties in personal and expert realms.

    PubMed

    Parrott, Roxanne; Hong, Soo Jung; Greenberg, Marisa

    2015-01-01

    The difficulty of diagnosing blood clots makes salient the question, "What role does family history awareness have for guiding lay and expert actions?" The authors examine the in-depth life reflection interviews of 20 women who experienced a first venous blood clot between the ages of 18 and 50 years, identifying causal attributions the women made for thrombosis after the event. Twelve participants described an understanding of the cascade of events linked to thrombosis, revealing that there is seldom a single cause. The other eight identified belief in a single determining cause for their thrombosis. The authors reflect on the symptoms the women experienced during the course of the clotting event, patterns of care that they executed to self-manage their blood clot, and their misdiagnoses associated with symptoms and care. The women recalled the patterns of care received through formal health care systems and the reported misdiagnoses linked to these interactions. The recollections reveal that the subtle nature of venous blood clot symptoms contributes to lay and expert misdiagnoses. Use of antibiotics and pain killers in the wake of misdiagnosis masks symptoms, contributing to costly delays in accurate diagnoses. Four women were aware of a family history of clotting when the event occurred, 13 had such a history but lacked awareness until the clotting event, and three had no known history. Among women with awareness of their family history, blood clot diagnosis occurred sooner, promoting survival and efficiencies in health care. Implications for communicating about family history of thrombosis are considered. PMID:24794077

  12. Detection and Type-Distribution of Human Papillomavirus in Vulva and Vaginal Abnormal Cytology Lesions and Cancer Tissues from Thai Women.

    PubMed

    Ngamkham, Jarunya; Boonmark, Krittika; Phansri, Thainsang

    2016-01-01

    Vulva and Vaginal cancers are rare among all gynecological cancers worldwide, including Thailand, and typically affect women in later life. Persistent high risk human papillomavirus (HR-HPV) infection is one of several important causes of cancer development. In this study, we focused on HPV investigation and specific type distribution from Thai women with abnormality lesions and cancers of the vulva and Vaginal. A total of ninety paraffin-embedded samples of vulva and Vaginal abnormalities and cancer cells with histologically confirmed were collected from Thai women, who were diagnosed in 2003-2012 at the National Cancer Institute, Thailand. HPV DNA was detected and genotyped using polymerase chain reaction and enzyme immunoassay with GP5+/ bio 6+ consensus specific primers and digoxigenin-labeled specific oligoprobes, respectively. The human β-globin gene was used as an internal control. Overall results represented that HPV frequency was 16/34 (47.1%) and 8/20 (40.0%) samples of vulva with cancer and abnormal cytology lesions, respectively, while, 3/5 (60%) and 16/33 (51.61%) samples of Vaginal cancer and abnormal cytology lesions, respectively, were HPV DNA positive. Single HPV type and multiple HPV type infection could be observed in both type of cancers and abnormal lesion samples in the different histological categorizes. HPV16 was the most frequent type in all cancers and abnormal cytology lesions, whereas HPV 18 was less frequent and could be detected as co-infection with other high risk HPV types. In addition, low risk types such as HPV 6, 11 and 70 could be detected in Vulva cancer and abnormal cytology lesion samples, whereas, all Vaginal cancer samples exhibited only high risk HPV types; HPV 16 and 31. In conclusion, from our results in this study we suggest that women with persistent high risk HPV type infection are at risk of developing vulva and Vaginal cancers and HPV 16 was observed at the highest frequent both of these, similar to the cervical cancer cases. Although the number of samples in this study was limited and might not represent the overall incidence and prevalence in Thai women, but the baseline data are of interest and suggest further study for primary cancer screening and/or developing the efficiency of prophylactic HPV vaccines in Thailand. PMID:27039737

  13. Characteristics of patients misdiagnosed with Alzheimer’s disease and their medication use: an analysis of the NACC-UDS database

    PubMed Central

    2013-01-01

    Background This study compared individuals whose clinical diagnosis of Alzheimer’s disease (AD) matched or did not match neuropathologic results at autopsy on clinical and functional outcomes (cognitive impairment, functional status and neuropsychiatric symptoms). The study also assessed the extent of potentially inappropriate medication use (using potentially unnecessary medications or potentially inappropriate prescribing) among misdiagnosed patients. Methods Longitudinal data from the National Alzheimer’s Coordinating Center Uniform Data Set (NACC-UDS, 2005–2010) and corresponding NACC neuropathological data were utilized to compare 88 misdiagnosed and 438 accurately diagnosed patients. Results Following adjustment of sociodemographic characteristics, the misdiagnosed were found to have less severe cognitive and functional impairment. However, after statistical adjustment for sociodemographics, dementia severity level, time since onset of cognitive decline and probable AD diagnosis at baseline, the groups significantly differed on only one outcome: the misdiagnosed were less likely to be depressed/dysphoric. Among the misdiagnosed, 18.18% were treated with potentially inappropriate medication. An additional analysis noted this rate could be as high as 67.10%. Conclusions Findings highlight the importance of making an accurate AD diagnosis to help reduce unnecessary treatment and increase appropriate therapy. Additional research is needed to demonstrate the link between potentially inappropriate treatment and adverse health outcomes in misdiagnosed AD patients. PMID:24354549

  14. Periampullary Diverticula Misdiagnosed as Cystic Pancreatic Lesions: A Review of 3 Cases

    PubMed Central

    Ng, Chee Hui; Lee, Chau Hung

    2016-01-01

    Case series Patient: Female, 67 • Male, 69 • Female, 65 Final Diagnosis: Periampullary diverticulum Symptoms: — Medication: — Clinical Procedure: Magnetic Resonance Imaging Specialty: Radiology Objective: Diagnostic/therapeutic accidents Background: Cystic lesions on the pancreatic head can mimic fluid-filled duodenal or periampullary diverticula. We reviewed a series of cases in which periampullary diverticula were misdiagnosed as cystic pancreatic lesions. Case Report: Case 1. A Chinese woman presented to the surgical outpatient clinic for intermittent upper abdominal discomfort. Contrast-enhanced MRI of the abdomen revealed a cystic-appearing lesion in the region of the pancreatic head, which was reported as a cystic pancreatic lesion. A follow-up scan showed this lesion to be filled with fluid, gas, and debris, suggestive of a periampullary diverticulum. Review of a prior CT scan confirmed a periampullary diverticulum. Case 2. A Chinese man with a history of chronic hepatitis B infection underwent an MRI of the liver, which revealed a cystic-appearing lesion in the region of the pancreatic head, reported as a cystadenoma or pseudocyst. The patient underwent an endoscopic ultrasound. A large periampullary diverticulum was discovered but there was no pancreatic head lesion. Case 3. A Chinese woman with a history total hysterectomy and bilateral salpingo-oophorectomy for ovarian malignancy underwent an MRI of the abdomen and pelvis. A cystic-appearing lesion was found in the region of the pancreatic head, which was reported as a cystadenoma or intraductal papillary mucinous neoplasm. Follow-up magnetic resonance cholangiopancreatography showed a signal void within, suggestive of gas within a periampullary diverticulum. Review of a prior CT scan showed a periampullary diverticulum. Conclusions: Periampullary diverticula, when fluid-filled, can be confused with cystic lesions in the pancreatic head. Radiologists should be aware of this potential pitfall. PMID:27052496

  15. Periampullary Diverticula Misdiagnosed as Cystic Pancreatic Lesions: A Review of 3 Cases.

    PubMed

    Ng, Chee Hui; Lee, Chau Hung

    2016-01-01

    BACKGROUND Cystic lesions on the pancreatic head can mimic fluid-filled duodenal or periampullary diverticula. We reviewed a series of cases in which periampullary diverticula were misdiagnosed as cystic pancreatic lesions. CASE REPORT Case 1. A Chinese woman presented to the surgical outpatient clinic for intermittent upper abdominal discomfort. Contrast-enhanced MRI of the abdomen revealed a cystic-appearing lesion in the region of the pancreatic head, which was reported as a cystic pancreatic lesion. A follow-up scan showed this lesion to be filled with fluid, gas, and debris, suggestive of a periampullary diverticulum. Review of a prior CT scan confirmed a periampullary diverticulum. Case 2. A Chinese man with a history of chronic hepatitis B infection underwent an MRI of the liver, which revealed a cystic-appearing lesion in the region of the pancreatic head, reported as a cystadenoma or pseudocyst. The patient underwent an endoscopic ultrasound. A large periampullary diverticulum was discovered but there was no pancreatic head lesion. Case 3. A Chinese woman with a history total hysterectomy and bilateral salpingo-oophorectomy for ovarian malignancy underwent an MRI of the abdomen and pelvis. A cystic-appearing lesion was found in the region of the pancreatic head, which was reported as a cystadenoma or intraductal papillary mucinous neoplasm. Follow-up magnetic resonance cholangiopancreatography showed a signal void within, suggestive of gas within a periampullary diverticulum. Review of a prior CT scan showed a periampullary diverticulum. CONCLUSIONS Periampullary diverticula, when fluid-filled, can be confused with cystic lesions in the pancreatic head. Radiologists should be aware of this potential pitfall. PMID:27052496

  16. Piriform sinus carcinoma with a paraneoplastic syndrome misdiagnosed as adult onset Still’s disease: a case report

    PubMed Central

    Yang, Liu; Li, Wen; Du, Jintao

    2015-01-01

    Paraneoplastic syndromes (PS) occur less commonly in association with otolaryngologic neoplasms than other carcinomas such as those of lung or breast. Piriform sinus carcinoma with PS is extremely rare. We here report a case of piriform sinus carcinoma accompanied by PS that was initially misdiagnosed as adult onset Still’s disease and describe our diagnosis and treatment. One lesson we have drawn from the experience of this misdiagnosis is that PS symptoms may manifest before the primary tumor is evident and complicate the diagnostic process. PMID:26770614

  17. The efficacy of high-intensity, focused ultrasound treatment for non-neoplastic epithelial disorders of the vulva.

    PubMed

    Zhou, W; Zhu, L; Zhou, H; Shen, K; Lang, J; Cui, Q; Shi, H

    2016-01-01

    Non-neoplastic epithelial disorders of the vulva (NNEDV) are common types of vulval lesions. Although corticosteroids represent a first-line treatment for NNEDV, concerns exist about the safety associated with long-term topical corticosteroid use. Recently, several clinical trials have identified high-intensity focused ultrasound (HIFU) as a promising treatment modality for NNEDV. The aim of this multi-center, randomized, controlled clinical trial was to investigate the efficacy of HIFU therapy in women with NNEDV based on histological alterations. We enrolled patients who were clinically diagnosed with NNEDV. They were randomized into 2 treatment groups: 1) halcinonide for 3 months or 2) HIFU once. A total of 123 patients were biopsied both prior to and after the therapy, and 62 and 61 patients were assigned to the HIFU and halcinonide groups, respectively. The histological changes were then analyzed. After the treatments, the therapeutic effects were observed in both groups. Comparing the diagnosis and alterations in lichenoid and sclerotic patterns and in chronic inflammation, we found statistically significant differences. Furthermore, when compared with the halcinonide group, the HIFU group exhibited enhanced curative effects that were statistically significant (P = 0.039). Based on the histological evidence from this randomized, controlled trial, HIFU represents an effective method for the treatment of NNEDV. PMID:27188744

  18. Thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus: a case report

    PubMed Central

    2011-01-01

    Introduction Non-convulsive status epilepticus is a form of epileptic seizure that occurs without convulsions. Recent reviews suggest that the diagnosis of non-convulsive status epilepticus remains difficult. Here, we report the case of a patient with thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus. Case presentation Our patient was a 68-year-old Japanese woman. The results of endocrine testing after her first episode of non-convulsive status epilepticus suggested latent subclinical hypothyroidism: she had elevated thyroid-stimulating hormone with normal levels of free tri-iodothyronine and free thyroxine. On examination, a diagnosis of thyroid disorder was not supported by other test results and our patient remained untreated. A follow-up examination revealed that her thyroid-stimulating hormone levels had spontaneously normalized. When she consulted another doctor for confusion, the transient increase in thyroid-stimulating hormone levels following non-convulsive status epilepticus was mistaken for subclinical hypothyroidism, and unfortunately treated with levothyroxine. Our patient then experienced levothyroxine-induced non-convulsive status epilepticus. Conclusions In this report, we suggested possible mechanisms for latent hypothyroid-like hormone abnormality following epileptic seizures and the possibility of provoking epileptic seizures by administering levothyroxine for misdiagnosed subclinical hypothyroidism. PMID:21892965

  19. Pleuritic chest pain from portal hypertensive gastropathy in ESRD patient with autosomal dominant polycystic kidney disease misdiagnosed as pericarditis.

    PubMed Central

    Onuigbo, Macaulay Amechi Chukwukadibia; Agbasi, Nneoma; Achebe, Jennifer; Odenigbo, Charles; Oguejiofor, Fidelis

    2016-01-01

    Portal hypertensive gastropathy (PHG) is a gastric mucosal lesion complicating portal hypertension, with higher prevalence in decompensated cirrhosis. PHG can sometimes complicate autosomal dominant polycystic kidney disease (ADPKD) due to the presence of multiple liver cysts. Besides, PHG is known to present as chest pain, with or without hematemesis. Other causes of chest pain in ADPKD include referred chest pain from progressively enlarging kidney cysts, and rare pericardial cysts. Chest pain, especially if pleuritic, in end-stage renal disease (ESRD) patients, is often ascribed to uremic pericarditis. We present recurrent pleuritic chest pain in a 24-year old ESRD patient with ADPKD that was initially misdiagnosed as uremic pericarditis. It was ultimately shown to represent symptomatic PHG with excellent therapeutic response to proton pump inhibitors. PMID:27069969

  20. Nonlesions, misdiagnoses, missed diagnoses, and other interpretive challenges in fish histopathology studies: a guide for investigators, authors, reviewers, and readers

    USGS Publications Warehouse

    Wolf, Jeffrey C.; Baumgartner, Wes A.; Blazer, Vicki; Camus, Alvin C.; Engelhardt, Jeffrey A.; Fournie, John W.; Frasca, Salvatore, Jr.; Groman, David B.; Kent, Michael L.; Khoo, Lester H.; Law, Jerry M.; Lombardini, Eric D.; Ruehl-Fehlert, Christine; Segner, Helmut E.; Smith, Stephen A.; Spitsbergen, Jan M.; Weber, Klaus; Wolfe, Marilyn J.

    2015-01-01

    Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negative impacts of publishing inaccurate histopathologic interpretations are not always fully appreciated. The objectives of this article are to illustrate a number of specific morphologic findings in commonly examined fish tissues (e.g., gills, liver, kidney, and gonads) that are frequently either misdiagnosed or underdiagnosed, and to address related issues involving the interpretation of histopathologic data. To enhance the utility of this article as a guide, photomicrographs of normal and abnormal specimens are presented. General recommendations for generating and publishing results from histopathology studies are additionally provided. It is hoped that the furnished information will be a useful resource for manuscript generation, by helping authors, reviewers, and readers to critically assess fish histopathologic data.

  1. Pneumocystis jiroveci pneumonia (PCP) misdiagnosed as pandemic influenza H1N1 in a renal transplant patient.

    PubMed

    Metan, Gokhan; Bozkurt, Ilkay; Koc, Ayse Nedret

    2011-09-01

    Respiratory infections are of particular concern in transplant patients. However, there is a significant overlap in the symptoms caused by different pathogens. Here, we report a case of Pneumocystis jiroveci pneumonia (PCP) in a renal transplant patient which was initially misdiagnosed as pandemic influenza H1N1. The patient did not improve under oseltamivir treatment and bronchoscopy was performed five days later after hospitalization. PCP was diagnosed by microscoping evaluation of bronchoalveolar lavage (BAL) fluid. Besides, BAL and serum of the patient yielded a large amount of 1,3-beta-D-glucan, a cellwall compotent of medically important mycoses including P. jiroveci. The patient was successfully treated with intravenous trimethoprim-sulfamethoxazole. Due to the lack of sensitivity of influenza case definitions, the attending physicians should be careful about alternative diagnoses particularly in transplant patients with severe respiratory infections. PMID:22037439

  2. Bilateral Paget's Disease of the Breast-Case Report of Long-Time Misdiagnosed Tumors with Underlying Ductal Carcinomas and Review of the Literature.

    PubMed

    Barth, Dietrich

    2014-01-01

    Paget's disease of the breast is often misdiagnosed. We report on a 72-year old patient with a history of 2.5 years without any malignant findings, followed by the identification of a bilateral Paget's disease with bilateral breast cancers. This case underlines how important histological examinations even in unusual clinical pictures are. PMID:24839561

  3. Update on intraepithelial neoplasia of the vulva: proceedings of a Workshop at the 2009 World Congress of the International Society for the Study of Vulvovaginal Diseases, Edinburgh, Scotland, September 2009.

    PubMed

    Heller, Debra S; van Seters, Manon; Marchitelli, Claudia; Moyal-Barracco, Michelline; Preti, Mario; van Beurden, Marc

    2010-10-01

    A workshop on updates on intraepithelial neoplasia of the vulva was held at the 2009 World Congress of the International Society for the Study of Vulvovaginal Diseases in Edinburgh, Scotland, September 2009. This is a review of the information presented. PMID:20885166

  4. Cancer of the Vulva

    MedlinePlus

    ... at a Glance Show More At a Glance Estimated New Cases in 2016 5,950 % of All New Cancer Cases 0.4% Estimated Deaths in 2016 1,110 % of All Cancer ... vulvar cancer is rare. Common Types of Cancer Estimated New Cases 2016 Estimated Deaths 2016 1. Breast ...

  5. Disorders of the Vulva

    MedlinePlus

    ... may be bumps that are dark pink in color. Treatment of lichen planus may include medicated creams or ointments, vaginal tablets, prescription pills, or injections. This condition is difficult to treat and usually involves long-term treatment and follow-up. What is vulvodynia? Vulvodynia ...

  6. [Cerebral sparganosis in a child: case report].

    PubMed

    Jones, Marta C; Agosti, María Rosa; D'Agustini, Marcelo; Uriarte, Valeria; Drut, Ricardo

    2013-01-01

    We are reporting the case of an 8-year-old boy with history of seizures in whom the pathology exam of 2.5 by 3 cm surgical specimen obtained from a cortical-subcortical area of the de right occipital lobe showed a chronic granulomatous inflammatory process with a Spirometras pp larva. The patient was born and lived several years at a rural area of Tarija (Bolivia). This appears to represent the first reported case of this parasitic infection localized to the brain of a child in Argentina. PMID:23381708

  7. Epstein-Barr virus associated T-cell lymphoproliferative disease misdiagnosed as ulcerative colitis: a case report

    PubMed Central

    Zheng, Xiaodan; Xie, Jianlan; Zhou, Xiaoge

    2015-01-01

    Epstein-Barr virus (EBV)-associated T-cell lymphoproliferative disease (LPD) is not uncommon in China, but gastrointestinal involvement is very rare. We report on an immunocompetent patient with EBV-associated T-cell LPD of the colon. The 26-year-old man was initially misdiagnosed with ulcerative colitis (UC). A colon biopsy revealed the presence of small to medium-sized lymphoid cells infiltrating the intestinal wall. The neoplastic cells expressed CD3, CD5, and granzyme B, not CD56. EBV-encoded small ribonucleic acid was detected in the tumor cells of the colon as well as the lymph node, and the T-cell receptor gene rearrangement result displayed ? gene monoclonal rearrangement. The patient died 2 moths after the diagnosis. The clinical course of EBV-associated T-cell LPD is aggressive and the prognosis is poor, the wrong diagnosis may delay treatment. Therefore, we should be very careful to prevent misdiagnosis. When patients have multiple intestinal ulcers that are not typical of UC and the clinical course is unusual, although morphology looks like inflammatory change, pathologist should consider the possibility of EBV-associated LPD. The treatment strategy and prognosis of these two diseases are different. PMID:26339440

  8. Hereditary inclusion body myopathy: A myopathy with unique topography of weakness, yet frequently misdiagnosed: Case series and review of literature

    PubMed Central

    Das, Biplab; Goyal, Manoj Kumar; Bhatkar, Sanat Ramchandra; Vinny, Pulikottil Wilson; Modi, Manish; Lal, Vivek; Gayathri, N.; Mahadevan, Anitha; Radotra, Bishan Dass

    2016-01-01

    Background: Hereditary inclusion body myopathy (HIBM) continues to be underrecognized clinically despite a characteristic topography of weakness with total sparing of quadriceps muscles and patient being wheelchair bound. We report seven patients of HIBM from four families in North India. Methods and Results: Seven patients from four different families were diagnosed to have HIBM. There was no consanguinity in any of the families. While one patient had two affected siblings, another had one affected siblings and the family history was noncontributory in two patients. Two of the siblings were available for examination and confirmed clinically to be suffering from HIBM. Among the seven patients, only one was still ambulatory at the time of diagnosis. Discussion: This is the first case report of occurrence of HIBM in North Indian population. Despite its unique clinical presentation, HIBM is frequently misdiagnosed resulting in unnecessary diagnostic and therapeutic interventions. A high index of suspicion of this rare myopathy along with proper clinical examination may go a long way in accurate prognostication and management of these patients. PMID:27011643

  9. Primary Immunodeficiency May Be Misdiagnosed as Cow's Milk Allergy: Seven Cases Referred to a Tertiary Pediatric Hospital

    PubMed Central

    Melo, Karina Mescouto; Dantas, Ellen; De Moraes-Pinto, Maria Isabel; Condino-Neto, Antonio; Gonzalez, Isabela G. S.; Mallozi, Marcia C.; Franco, Jackeline M.; Costa-Carvalho, Beatriz T.

    2013-01-01

    Introduction. The presence of eczema and gastrointestinal manifestations are often observed in cow's milk allergy (CMA) and also in some primary immunodeficiency diseases (PID). Objective. To describe 7 patients referred to a tertiary allergy/immunology Center with a proposed diagnosis of CMA, who were ultimately diagnosed with PID. Methods. This was a retrospective study based on clinical and laboratory data from medical records. Results. Seven patients (6 males) aged between 3 mo and 6 y were referred to our clinic with a proposed diagnosis of CMA. They presented with eczema and/or gastrointestinal symptoms. Five were receiving replacement formula. All patients presented with other clinical features, including severe/recurrent infections unrelated to CMA, and two of them had a positive family history of PID. Laboratory tests showed immune system dysfunctions in all patients. Hyper-IgE and Wiskott-Aldrich syndromes, CD40L deficiency, severe combined immunodeficiency, X-linked agammaglobulinemia, transient hypogammaglobulinemia of infancy, and chronic granulomatous disease were diagnosed in these children. In conclusion, allergic diseases and immunodeficiency are a result of a different spectrum of abnormalities in the immune system and may be misdiagnosed. Educational programs on PID among clinical physicians and pediatricians can reduce the occurrence of this misdiagnosis. PMID:24198970

  10. Paraneoplastic stiff person syndrome associated with colon cancer misdiagnosed as idiopathic Parkinson’s disease worsened after capecitabine therapy

    PubMed Central

    2013-01-01

    Objectives To refresh clinical diagnostic dilemmas in patients presenting with symptoms resembling to those of parkinsonism, to report rare association of colon cancer and paraneoplastic stiff person syndrome (SPS), and to draw attention on the possible correlation of capecitabine therapy with worsening of paraneoplastic SPS. Methods Case report of the patient with paraneoplastic SPS due to colon cancer that was misdiagnosed as idiopathic Parkinson’s disease (iPD), whose symptoms worsened after beginning adjuvant capecitabine chemotherapy. Results We describe a 55-year-old woman with subacute onset of symmetrical stiffness and rigidity of the truncal and proximal lower limb muscles that caused lower body bradykinesia, gait difficulties, and postural instability. Diagnose of iPD was made and levodopa treatment was initiated but failed to provide beneficial effect. Six months later, colon cancer was discovered and the patient underwent surgical procedure and chemotherapy with capecitabine thereafter. Aggravation of stiffness, rigidity, and low back pain was observed after the first chemotherapy cycle and capecitabine was discontinued. Furthermore, levodopa was slowly discontinued and low dose of diazepam was administered which resulted in partial resolution of the patient’s symptoms. Conclusion Paraneoplastic SPS is rare disorder with clinical features resembling those of parkinsonian syndrome and making the correct diagnosis remains a challenge. The diagnosis of parkinsonian syndrome should be re-examined if subsequent examinations discover an associated malignant process. Although it remains unclear whether the patients with history of SPS are at the greater risk for symptoms deterioration after administration of capecitabine, clinicians should be aware of capecitabine side effects because recognition and appropriate management can prevent serious adverse outcomes. PMID:24028681

  11. Misdiagnosed Hypomanic Symptoms in Patients with Treatment-Resistant Major Depressive Disorder in Italy: Results from the Improve Study

    PubMed Central

    Francesca, Moro Maria; Efisia, Lecca Maria; Alessandra, Ghillani M.; Marianna, Alacqua; Giovanni, Carta Mauro

    2014-01-01

    Background:Undiagnosed and therefore inadequately treated hypomanic symptoms may be a leading cause of drug resistance in depression diagnosed as unipolar (major depressive disorder, MDD). The purpose of the IMPROVE study was to identify the rate of misdiagnoses in patients with treatment-resistant MDD by screening for the presence of previous hypomanic episodes, and to study the characteristics of those patients with a positive history of hypomania. Methods:Patients attending 29 psychiatric units throughout Italy with a diagnosis of MDD who were resistant to anti-depressant treatment were included in this multicentre, observational single visit study. The Hypomania Checklist 32 (HCL-32) was administered to detect underlying bipolarity. Results: Among the 466 enrolled patients, 256 (57.40%) were positive at screening for a previous hypomanic episode (HCL-32 ≥12), therefore suggesting a misdiagnosis. These patients scored higher than those with a negative history in both the “active/elated hypomania” (11.27±3.11 vs 3.57±3.05; P<0.0001) and “irritable/risk-taking hypomania” (2.87±2.03 vs 2.06±1.73; P<0.001) HCL-32 sub-scales. Patients with a positive history of hypomania were younger, had a higher number of previous depressive episodes and a higher frequency of comorbid conditions compared to those with a negative history. Conclusions:This study suggests that screening for hypomania in MDD-resistant patients facilitates identification of a notable proportion of undiagnosed cases of bipolar spectrum disorder. Patients with a positive history of hypomania at screening had a demographic/clinical bipolar-like profile that included young age, higher number of previous depressive episodes and higher frequency of comorbid conditions. They also had both higher active and irritable hypomania symptom scores. PMID:24761153

  12. Squamous Cell Carcinoma of the Vulva: A Subclassification of 97 Cases by Clinicopathologic, Immunohistochemical, and Molecular Features (p16, p53, and EGFR).

    PubMed

    Dong, Fei; Kojiro, Sakiko; Borger, Darrell R; Growdon, Whitfield B; Oliva, Esther

    2015-08-01

    Squamous cell carcinomas (SCCs) of the vulva develop through human papilloma virus (HPV)-associated or HPV-independent pathways, but the relationship between pathogenesis, classification, and prognosis of these tumors is controversial. Therefore, we review the morphology, immunophenotype, and select molecular features of a consecutive series of 97 patients with vulvar SCC with a median clinical follow-up of 3.6 years. Tumors were histologically classified as basaloid (13), warty (11), mixed basaloid and warty (1), keratinizing (68), nonkeratinizing (3), and sarcomatoid (1). Diffuse p16 expression was associated with younger age at presentation (P<0.0001), basaloid and warty carcinoma subtypes (P<0.0001), and usual vulvar intraepithelial neoplasia (P<0.0001) and was negatively associated with p53 immunopositivity (P=0.0008). Five keratinizing SCCs showed p16 and p53 coexpression, but only 1 was positive for high-risk HPV by in situ hybridization. Among 8 of 36 tumors with EGFR gene amplification, 4 were p53 positive but none p16 positive. In a Cox regression model, early clinical stage (P<0.006), p16 expression (P=0.002), and absent p53 expression (P=0.02) were independent predictors of improved overall survival. These findings utilize morphologic and immunohistochemical analysis to support HPV-associated and HPV-independent pathogenesis of vulvar SCCs and support p16 and p53 immunohistochemistry as markers of disease biology and clinical outcome. PMID:26171917

  13. CO2 laser ablation of external genital lesions with a SwiftLase flashscanner: treatment of extramammary Paget's disease of the vulva, penile condylomata, and other lesions

    NASA Astrophysics Data System (ADS)

    Sacknoff, Eric J.; Schweitzer, Jay; Slatkine, Michael; Mead, Douglass S.

    1995-05-01

    The ability to vaporize extremely thin layers of epithelial tissue without any char and with minimal thermal necrosis is extremely advantageous in the treatment of superficial lesions of the external genitalia. We present a novel CO2 laser `SwiftLase' flashscan technology capable of providing char free ablation of 3 mm diameter lesions with only 150 micron residual thermal necrosis depth at power level as low as 10 watts. These power levels are achievable with a small transportable CO2 laser. The SwiftLaser is a miniature opto- mechanical scanner which homogeneously covers a 3 mm diameter surface with a 0.1 mm spot size focused beam within 0.1 seconds. The instantaneous beam's dwelling time is 1 millisecond. The instantaneous power density level at the focal point is higher than the threshold for char free ablation, thus providing a large char free ablation crater. Since depth of each ablated layer is 0.1 mm, the depth of treatment can be precisely controlled. The SwiftLaser technology has extensively and successfully been used in the last two years for the treatment of HPV in female lower tracts (Vulvectomy). The same technique may be performed with extramammary Paget's disease of the vulva, penile condylomata, and other epithelial disorders of the external genitalia without damage to surrounding healthy tissue. Technique and clinical results will be discussed.

  14. Extranodal natural killer/T-cell lymphoma, nasal type, involving the skin, misdiagnosed as nasosinusitis and a fungal infection: A case report and literature review.

    PubMed

    Zheng, Yan; Jia, Jinjing; Li, Wensheng; Wang, Juan; Tian, Qiong; Li, Zhengxiao; Yang, Jing; Dong, Xinyu; Pan, Ping; Xiao, Shengxiang

    2014-11-01

    The present study reports a case of extranodal natural killer (NK)/T-cell lymphoma, nasal type, involving the skin. The clinical manifestations, pathological characteristics, treatment and prognosis of the case were analyzed to improve the clinical diagnosis and treatment for this disease. The patient was a 56-year-old male, presenting with dark red nodules and plaques that had been visible on the nose for half a year. Based on the skin lesions and histopathological and immunohistochemical examination results, the patient was diagnosed with extranodal NK/T-cell lymphoma, nasal type. This disease has unique histopathological and immunohistochemical features and a high malignancy. The condition tends to be misdiagnosed and has a poor prognosis, but seldom involves the skin. In the present case, only radiotherapy was performed, with no relapse occurring within 6 months. PMID:25289105

  15. Extranodal natural killer/T-cell lymphoma, nasal type, involving the skin, misdiagnosed as nasosinusitis and a fungal infection: A case report and literature review

    PubMed Central

    ZHENG, YAN; JIA, JINJING; LI, WENSHENG; WANG, JUAN; TIAN, QIONG; LI, ZHENGXIAO; YANG, JING; DONG, XINYU; PAN, PING; XIAO, SHENGXIANG

    2014-01-01

    The present study reports a case of extranodal natural killer (NK)/T-cell lymphoma, nasal type, involving the skin. The clinical manifestations, pathological characteristics, treatment and prognosis of the case were analyzed to improve the clinical diagnosis and treatment for this disease. The patient was a 56-year-old male, presenting with dark red nodules and plaques that had been visible on the nose for half a year. Based on the skin lesions and histopathological and immunohistochemical examination results, the patient was diagnosed with extranodal NK/T-cell lymphoma, nasal type. This disease has unique histopathological and immunohistochemical features and a high malignancy. The condition tends to be misdiagnosed and has a poor prognosis, but seldom involves the skin. In the present case, only radiotherapy was performed, with no relapse occurring within 6 months. PMID:25289105

  16. [Accessory breast on the vulva].

    PubMed

    Godoy-Gijón, E; Yuste-Chaves, M; Santos-Briz, A; Esteban-Velasco, C; de Unamuno-Pérez, P

    2012-04-01

    We describe a 24-year-old woman with a subcutaneous swelling in the left inferior pubic region. Histology revealed ectopic breast tissue. Vulvar tumors are uncommon and the presence of ectopic breast tissue in this region is extremely rare. In these cases, patients usually consult for a mass that varies in size with hormonal changes, typically during pregnancy or breast-feeding, or that has associated neoplastic changes. In our patient, the mass had grown progressively with no identifiable underlying hormonal association or neoplasm. We therefore classified it as ectopic breast tissue presenting as a subcutaneous mass. PMID:21798481

  17. Pilomatrix carcinoma of the vulva

    PubMed Central

    Song, Mihae; Chekmareva, Marina; Bachmann, Gloria; Gibbon, Darlene

    2015-01-01

    Background Pilomatrix carcinomas are rare, frequently occurring in older male patients. We report a case of vulvar pilomatrix carcinoma in a 30-year-old woman, the second known reported case occurring on the external genitalia. Case A 30-year-old female originally presented at an outside institution for the management of an asymptomatic vulvar mass that was biopsied and read as invasive squamous cell carcinoma. Pathology review at our institution reclassified the vulvar mass as a low-grade pilomatrix carcinoma. The patient underwent radical hemivulvectomy without an inguinal–femoral groin node dissection. She has remained without evidence of disease recurrence for more than 5 years since her diagnosis. Conclusion Pilomatrix carcinoma can be confused for an invasive squamous cell carcinoma. Due to its low risk of metastases, a less radical surgical approach can be taken. Consideration of this unusual malignancy is important in the determination of appropriate management. PMID:26937479

  18. Paget disease of the vulva.

    PubMed

    van der Linden, M; Meeuwis, K A P; Bulten, J; Bosse, T; van Poelgeest, M I E; de Hullu, J A

    2016-05-01

    In this review, we provide an overview of the clinical aspects, histopathology, molecular genetics, and treatment options for Vulvar Paget's Disease (VPD), a rare skin disease, most commonly found in postmenopausal Caucasian women. The underlying cause of VPD remains not well understood. VPD is rarely associated with an underlying urogenital, gastrointestinal or vulvar carcinoma. In approximately 25% of the cases, VPD is invasive; in these cases, the prognosis is worse than in non-invasive cases. Recurrence rates in invasive VPD are high: 33% in cases with clear margins, and even higher when surgical margins are not clear, regardless of invasion. Historically, surgical excision has been the treatment of choice. Recent studies show that imiquimod cream may be an effective and safe alternative. PMID:26971063

  19. Tracheopathia osteoplastica misdiagnosed as asthma.

    PubMed

    Hayes, Don

    2007-05-01

    Tracheopathia osteoplastica (TPO) is a rare disorder characterized by cartilaginous or bony mucosal nodules in the tracheobronchial tree. Due to most patients being asymptomatic, the majority are diagnosed post-mortem. If symptoms are present, they typically include chronic cough, dyspnea, hemoptysis, hoarseness, and wheezing, with some of these symptoms overlapping with asthma. This case report describes an adult female with chronic cough who was diagnosed with asthma that was refractory to therapy for 8 years. Computed tomography (CT) of the chest revealed several soft tissue masses in the trachea with bronchoscopy revealing TPO in the upper portion of the trachea. She was diagnosed with TPO and started on airway clearance and a nasal corticosteroid spray with resolution of the cough at follow-up 3 months later. PMID:17530521

  20. Dermatoses misdiagnosed as deliberate injuries.

    PubMed

    Asati, Dinesh P; Singh, Sandeep; Sharma, Vinod K; Tiwari, Shreyansh

    2012-10-01

    Examination of non-accidental injuries on a body should be done with caution, as often skin diseases can mimic deliberate injuries. Patients with active dermatoses or their residual/post-inflammatory spots seen during autopsy can generate false alarms or suspicion of burns, child abuse or battering, sexual assault or other medicolegal cases. The inability to distinguish between a mechanical injury and skin disease can cause unnecessary anxiety and can complicate medicolegal investigations. Many times, an elaborate history to find out the aetiology of the lesion is either unavailable or not reliable as in the cases of young children, insane or mentally subnormal patients or in medicolegal deaths. The greatest chance of misinterpretation may be in cases of extensive denudation of the skin seen in severe drug reactions like toxic epidermal necrolysis, which can be mistaken for scald burns. Other important cases include bruises diagnosed on seeing discoloured spots on the skin or genital lesions raising the suspicion of sexual abuse in children. This diagnostic dilemma can also lead to undue forensic investigations, imprecise expert opinions and distress to patients or their family members. This review aims to generate awareness about proper interpretation of findings with an open mind, the clues to differentiate between true and false injuries and the management thereof. PMID:22623714

  1. Misdiagnosing New Hires Is Costly.

    PubMed

    Hoagland-Smith, Leanne

    2015-01-01

    Winning the war for talent will propel profitable practices ahead of the competitive flow. Today there are psychometric tools that can support busy leaders who are tired of a range of disappointments, from mis-hires to underperforming employees. This article discusses several of these assessment tools, addressing when and where they should be used. Additionally, it shows how by adopting the three Ds--Diagnosis, Determine, and Decide--you can stop losing money, stop the employee aggravation, and reduce your stress. PMID:26399040

  2. Sports Hernia: Misdiagnosed Muscle Strain

    MedlinePlus

    ... Processes Student & Trainee Info Educational Stakeholders Info Video Library Governance FAQs Single GME Accreditation System Newsletter Archive ... Are DOs Certified? Search for a DO Health Library Osteopathic Manipulative Treatment Becoming a DO Video Library ...

  3. Differential diagnosis of a carcinoma of the maxillary sinus that resembles a sparganum infection: A case report

    PubMed Central

    YU, MEI-HONG; CHEN, CHUN-LEI; LIU, XIAO-LI; XU, XIAO-WEI

    2015-01-01

    Primary malignant tumors of the maxillary sinuses are rare. The present study reports the case of a maxillary sinus adenocarcinoma that was misdiagnosed as a frog sparganum infection, and discusses the differential diagnosis between the two diseases. The patient was ultimately diagnosed with a carcinoma of the left maxillary sinus that presented as a progressive mass in the left eye and the maxillary sinus. Eosinophilic infiltration was observed in the subcutaneous tissue, and the patient had experienced previous exposure to undercooked frog. Although an anti-sparganum ELISA was performed and the results were negative, a sparganosis infection was initially diagnosed. However, following the application of anti-sparganosis treatment, no improvements were observed. Histological examination of an orbital mass resection revealed an adenocarcinoma with bone metastases. To the best of our knowledge, the present study is the first to report a maxillary sinus carcinoma misdiagnosed as sparganosis. Therefore, the findings of the current study should be considered in the differential diagnosis between a carcinoma of the maxillary sinus and sparganosis. Avoidance of misdiagnosis at an early stage is crucial for effective diagnosis and treatment of sinonasal malignancies. PMID:26622486

  4. Three-Day Combination Treatment for Vulvovaginal Candidosis with 200?mg Clotrimazol Vaginal Suppositories and Clotrimazol Cream for the Vulva is Significantly Better than Treatment with Vaginal Suppositories Alone an Earlier, Multi-Centre, Placebo-Controlled Double Blind Study

    PubMed Central

    Mendling, W.; Schlegelmilch, R.

    2014-01-01

    Problem: According to the guidelines, acute vulvovaginal candidosis (VVC) may be treated vaginally, through a combination of vaginal treatment and cream for the vulva or orally. However, there is a lack of investigations into whether combined treatment for the vagina and vulva achieves better results than vaginal treatment alone. Method: In 1999, 160 patients with vulvovaginal candidosis from ten German gynaecological practices were included in a study and treated on a randomised basis with three 200?mg clotrimazol vaginal suppositories?=?clotrimazol 2?% cream (verum n?=?79) or + placebo (active-ingredient-free cream base n?=?79). The examinations took place before treatment (T1), six to eight days following the end of treatment (T2) and approximately four weeks following the end of treatment (T3). In addition to demographic data, the clinical findings of each investigation were documented in a standardised way and a native preparation and a fungal culture were taken. The doctor and patient evaluated the healing process and tolerance. The main efficacy variables were the pre/post difference scores for extravaginal redness. Results: On T1, there was no difference between the two groups. By T2, there was a significant difference in the extent of extravaginal redness between the verum and the placebo groups (p?=?0.0002), as well as in the subgroup of the per-protocol analysis (verum 64, placebo 70 patients, p?=?0.0015). Genital itching or burning had entirely disappeared in 51?% and 56?% of patients respectively in the verum group and in only 30?% and 45?% of patients in the placebo group on T2 (p?=?0.0181). There was no difference in intravaginal redness on T1 and T2 in either group. The overall assessment by the doctor went accordingly (p?=?0.0004). On T1, the extravaginal fungal culture was positive in 75 women in the verum group and in 76 women in the placebo group. On T2, however, this was positive in 51.9?% (verum) and 73.1?% (placebo) of cases, and a positive culture was evinced in the vagina in 6 vs. 8 women (7.5 vs. 10.1?%, p?=?0.3802). The local tolerance in both groups was 70?% very good, and 29 vs. 27?% good. After four weeks (T3), 16 out of 23 patients in the verum group and only 8 out of 21 in the placebo group had negative extravaginal fungal cultures. Discussion: There is a lack of studies into the issue of whether vaginal treatment or combined vulvovaginal treatment of acute VVC would be more advantageous. However, there are two studies that support the significant results of this paper that when it comes to acute VVC, the combination of three 200?mg clotrimazol vaginal suppositories with clotrimazol cream 2?% is better than with vaginal suppositories alone. PMID:25076792

  5. Fox–Fordyce disease of the vulva

    PubMed Central

    Gurusamy, Lakshmipriya; Jegadeesan, Muhilan; Jayakumar, Salai

    2016-01-01

    Fox–Fordyce disease is a rare, chronic skin disorder which affects the apocrine areas. This disease is due to the obstruction of the apocrine sweat duct. Extragenital regions are commonly affected than the genital region. We, herein, report a case of Fox–Fordyce in a female, with onset in the fifth decade and involving only the genital region. PMID:27190415

  6. Surgery for Cancer of the Vulva (Vulvectomy)

    MedlinePlus

    ... Overcoming depression Dealing with grief and loss Rebuilding self-esteem Good communication: The key to building a successful ... ACS Sites Bookstore ACS CAN Marketplace Cancer Atlas Global Health Finish the Fight Press Room Mobile Site ...

  7. Thalamic Pain Misdiagnosed as Cervical Disc Herniation

    PubMed Central

    Lim, Tae Ha; Choi, Soo Il; Yoo, Jee In; Choi, Young Soon; Lim, Young Su; Sang, Bo Hyun; Bang, Yun Sic

    2016-01-01

    Thalamic pain is a primary cause of central post-stroke pain (CPSP). Clinical symptoms vary depending on the location of the infarction and frequently accompany several pain symptoms. Therefore, correct diagnosis and proper examination are not easy. We report a case of CPSP due to a left acute thalamic infarction with central disc protrusion at C5-6. A 45-year-old-male patient experiencing a tingling sensation in his right arm was referred to our pain clinic under the diagnosis of cervical disc herniation. This patient also complained of right cramp-like abdominal pain. After further evaluations, he was diagnosed with an acute thalamic infarction. Therefore detailed history taking should be performed and examiners should always be aware of other symptoms that could suggest a more dangerous disease. PMID:27103967

  8. Cerebral Vein Thrombosis Misdiagnosed and Mismanaged

    PubMed Central

    Sasidharan, P. K.

    2012-01-01

    Cerebral venous thrombosis (CVT) should be considered in the differential diagnosis of all unexplained CNS disorders of sudden onset. Etiological factors are often subclinical forms of several common thrombophilic states occurring together, rather than the typical inherited and rare causes. Diagnosis is missed because of the heterogeneity in clinical presentation and etiological factors. In several patients with the so called idiopathic CVT nutritional deficiencies and lifestyle issues are more important factors in pathogenesis, rather than single rarer causes. High index of suspicion is the key to diagnosis. Clinical skill has to be fine tuned to diagnose the problem and to identify all the etiological factors. Radiology is essential for diagnosis but relying on radiology alone will lead to missing several cases and even erroneous diagnosis. It is inappropriate to proceed prematurely to laboratory investigations, forgetting proper clinical evaluation by studying diet, lifestyle, and environment of the patients. Success in managing lies in identifying all the contributory causes and correcting all of them giving excellent outcome almost always. Clinical observations based on case series and sharing of such information alone are the means to arrive at a consensus in diagnosis and management. PMID:22567255

  9. Factitious Ulcer Misdiagnosed as Pyoderma Gangrenosum.

    PubMed

    Conde Montero, Elena; Sánchez-Albisua, Begoña; Guisado, Soledad; Ángeles Martín-Díaz, María; Balbín-Carrero, Eva; Valdivelso-Ramos, Marta; de la Cueva Dobao, Pablo

    2016-02-01

    Dermatitis artefacta may represent a real challenge for the clinician. As the patient does not admit self-inflicting the lesions, misdiagnosis with other diseases, such as pyoderma gangrenosum, is common. Consequently, these patients normally go through unnecessary tests and receive potentially harmful treatments as clinicians determine their diagnosis. The authors present the case of a recurrent factitious abdominal ulcer that was initially diagnosed and treated as pyoderma gangrenosum. This report focuses on the necessity of suspecting dermatitis artefacta when morphology, history, and treatment failures are difficult to explain. It is essential to establish a supportive and confident approach and avoid initial confrontation. In-patient treatment may be useful and long-term followup may prevent recurrences. PMID:26891139

  10. Rhinolith misdiagnosed as allergic rhinitis: case report

    PubMed Central

    Aljfout, Qais; Saraireh, Mohammad; Maita, Abdullah

    2016-01-01

    Foreign body neglected in the nasal cavity for many years leads to the formation of a rhinolith, which gradually increases in size. Nasal obstruction and persistent foul smelling nasal discharge usually are the main presenting symptoms, although some might be silent. This paper presents and discuss a case of 19-year-old female patient whose main complaint was nasal obstruction for many years and treated as allergic rhinitis. Diagnosis was confirmed with computed tomography scan, and it was removed endoscopically without complications. We think that proper examination, which includes endoscopic evaluation, should be done to reach the diagnosis. A computed tomography scan confirmed the diagnosis and helped in planning the best treatment option. PMID:27053994

  11. Dendritic Myxofibrolipoma: Often Misdiagnosed as Sarcoma

    PubMed Central

    Al-Maskery, Awatif Y.; Al-Sidairy, Salem M.; Al-Hamadani, Aisha S.

    2011-01-01

    The author describes a benign soft tissue tumor that could be easily mistaken for sarcoma. It represents a combined feature of solitary fibrous tumor and spindle cell lipoma. The clinical presentation, diagnosis, and management of this lesion are discussed. It highlights the importance of proper diagnosis to prevent unnecessary and ineffective treatment by clinicians as the complete excision of this lesion is the treatment of choice and recurrence is very unlikely. It is believed that this case is the first reported case of dendritic myxofibrolipoma occurring in the lower lip mucosa in an Omani patient. PMID:22942947

  12. Idiopathic Thrombocytopenic Purpura Misdiagnosed as Hereditary Angioedema

    PubMed Central

    Andersen, Michelle Fog; Bygum, Anette

    2015-01-01

    Hereditary angioedema is a rare, but potentially life-threatening genetic disorder that results from an autosomal dominant trait. It is characterized by acute, recurrent attacks of severe local edema, most commonly affecting the skin and mucosa. Swelling in hereditary angioedema patients does however not always have to be caused by angioedema but can relate to other concomitant disorders. In this report we are focusing on misdiagnosis in a patient with known hereditary angioedema, whose bleeding episode caused by idiopathic thrombocytopenic purpura was mistaken for an acute attack of hereditary angioedema. The case illustrates how clinicians can have difficulties in handling patients with rare diseases, especially in the emergency care setting. PMID:26819784

  13. Methamphetamine Ingestion Misdiagnosed as Centruroides sculpturatus Envenomation

    PubMed Central

    Strommen, Joshua; Shirazi, Farshad

    2015-01-01

    The authors present a case report of a 17-month-old female child who ingested a large amount of methamphetamine that looked very similar clinically to a scorpion envenomation specific to the southwestern United States by the species Centruroides sculpturatus. The child was initially treated with 3 vials of antivenom specific for that scorpion species and showed a transient, though clinically relevant neurologic improvement. Her clinical course of sympathomimetic toxicity resumed and she was treated with intravenous fluids and benzodiazepines after blood analysis showed significant levels of d-methamphetamine. This case report is to specifically underline the clinical confusion in discerning between these two conditions and the realization of limited and/or expensive resources that may be used in the process. PMID:25649670

  14. Acanthocephalan infection and sparganosis in a green tree snake (Dendrelaphis punctulata).

    PubMed

    Hill, A G; Ladds, P W; Spratt, D M

    2014-09-01

    Acanthocephalan and spargana parasites were identified within a body wall mass during exploratory surgery in a wild green tree snake. Acanthocephalan parasites have not previously been reported in this species. Surgical excision, the treatment of choice, could not be achieved because of the extensive infiltration of the coelomic cavity. PMID:25156057

  15. Thirty-Seven Human Cases of Sparganosis from Ethiopia and South Sudan Caused by Spirometra Spp.

    PubMed

    Eberhard, Mark L; Thiele, Elizabeth A; Yembo, Gole E; Yibi, Makoy S; Cama, Vitaliano A; Ruiz-Tiben, Ernesto

    2015-08-01

    Thirty-seven unusual specimens, three from Ethiopia and 34 from South Sudan, were submitted since 2012 for further identification by the Ethiopian Dracunculiasis Eradication Program (EDEP) and the South Sudan Guinea Worm Eradication Program (SSGWEP), respectively. Although the majority of specimens emerged from sores or breaks in the skin, there was concern that they did not represent bona fide cases of Dracunculus medinensis and that they needed detailed examination and identification as provided by the World Health Organization Collaborating Center (WHO CC) at Centers for Disease Control and Prevention (CDC). All 37 specimens were identified on microscopic study as larval tapeworms of the spargana type, and DNA sequence analysis of seven confirmed the identification of Spirometra sp. Age of cases ranged between 7 and 70 years (mean 25 years); 21 (57%) patients were male and 16 were female. The presence of spargana in open skin lesions is somewhat atypical, but does confirm the fact that populations living in these remote areas are either ingesting infected copepods in unsafe drinking water or, more likely, eating poorly cooked paratenic hosts harboring the parasite. PMID:26055739

  16. Thirty-Seven Human Cases of Sparganosis from Ethiopia and South Sudan Caused by Spirometra Spp.

    PubMed Central

    Eberhard, Mark L.; Thiele, Elizabeth A.; Yembo, Gole E.; Yibi, Makoy S.; Cama, Vitaliano A.; Ruiz-Tiben, Ernesto

    2015-01-01

    Thirty-seven unusual specimens, three from Ethiopia and 34 from South Sudan, were submitted since 2012 for further identification by the Ethiopian Dracunculiasis Eradication Program (EDEP) and the South Sudan Guinea Worm Eradication Program (SSGWEP), respectively. Although the majority of specimens emerged from sores or breaks in the skin, there was concern that they did not represent bona fide cases of Dracunculus medinensis and that they needed detailed examination and identification as provided by the World Health Organization Collaborating Center (WHO CC) at Centers for Disease Control and Prevention (CDC). All 37 specimens were identified on microscopic study as larval tapeworms of the spargana type, and DNA sequence analysis of seven confirmed the identification of Spirometra sp. Age of cases ranged between 7 and 70 years (mean 25 years); 21 (57%) patients were male and 16 were female. The presence of spargana in open skin lesions is somewhat atypical, but does confirm the fact that populations living in these remote areas are either ingesting infected copepods in unsafe drinking water or, more likely, eating poorly cooked paratenic hosts harboring the parasite. PMID:26055739

  17. Recurrent aggressive angiomyxoma of the vulva - a rare presentation.

    PubMed

    Sengupta, Sandip Kumar; Bhattacharyya, Sanjay Kumar; Saha, Shyama Prasad; Roy, Hironmoy; Sarkar, Amarendra Nath

    2014-05-01

    We describe here a case of a 38-year-old lady presenting with a about 5x4cm in size swelling on the left labia majora. She had similar type of swelling 2 years back which was treated surgically. FNAC report of the present mass revealed angiomyxoma. In view of its' recurrent nature wide local surgical excision of the mass was done. Histopathology report confirmed the diagnosis of angiomyxoma. The lady is under follow up and there is no further recurrence till date. PMID:24995218

  18. Sentinel node techniques in cancer of the vulva.

    PubMed

    de Hullu, Joanne A; van der Zee, Ate G J

    2003-02-01

    The sentinel lymph node procedure, with the combined technique (preoperative lymphoscintigraphy with (99m)Technetium-labeled Nanocolloid and Patente Blue V ), is a promising staging technique for patients with vulvar cancer. The clinical implementation of the sentinel lymph node procedure and the role of additional histopathologic techniques of the sentinel lymph nodes are under investigation. PMID:12521546

  19. Giant Condyloma Acuminatum of Vulva Frustrating Treatment Challenge

    PubMed Central

    Niazy, Feizollah; Rostami, Khalil; Motabar, Amir Reza

    2015-01-01

    Giant condylomata are not usually seen nowadays in developed nations, but such cases are still seen in the under-resourced countries. Condylomata acuminata are commonly transmitted through sexual intercourse. Generally diagnosed based on their appearance. Giant condyloma acuminata also named Buschke- Löwenstein tumour (BLT) is a slow growing cauliflower-like tumor, locally aggressive and destructive, with possible malignant transformation. Common clinical treatment of anogenital warts is conservative, however, in extreme cases conservative therapy is insufficient and surgical excision is required. A case of common presentation of giant condylomata in a 50 years old, divorced, multiparous woman is presented and the literature is reviewed. She presented with 15 years history of slowly progressive vulval lesion and associated itching, contact bleeding, malodorous vaginal discharge and difficulty in walking. She had previously been treated with podophyllin and cryosurgery without success. The growth measured 30×10 cm in each side and was successfully excised with no evidence of malignancy concomitant and reconstruction also done. PMID:26284185

  20. Giant Condyloma Acuminatum of Vulva Frustrating Treatment Challenge.

    PubMed

    Niazy, Feizollah; Rostami, Khalil; Motabar, Amir Reza

    2015-07-01

    Giant condylomata are not usually seen nowadays in developed nations, but such cases are still seen in the under-resourced countries. Condylomata acuminata are commonly transmitted through sexual intercourse. Generally diagnosed based on their appearance. Giant condyloma acuminata also named Buschke- Löwenstein tumour (BLT) is a slow growing cauliflower-like tumor, locally aggressive and destructive, with possible malignant transformation. Common clinical treatment of anogenital warts is conservative, however, in extreme cases conservative therapy is insufficient and surgical excision is required. A case of common presentation of giant condylomata in a 50 years old, divorced, multiparous woman is presented and the literature is reviewed. She presented with 15 years history of slowly progressive vulval lesion and associated itching, contact bleeding, malodorous vaginal discharge and difficulty in walking. She had previously been treated with podophyllin and cryosurgery without success. The growth measured 30×10 cm in each side and was successfully excised with no evidence of malignancy concomitant and reconstruction also done. PMID:26284185

  1. Misdiagnosing the Teacher Quality Problem. CPRE Policy Briefs. RB-49

    ERIC Educational Resources Information Center

    Ingersoll, Richard M.

    2007-01-01

    This issue of CPRE Policy Briefs summarizes the findings on issues related to teacher quality in the chapter by the author in the book, "The State of Education Policy Research" (Cohen, Fuhrman, Mosher, Eds., 2007). This report also draws on discussions that took place during a summer, 2006, policy briefing on teacher labor-market issues held in…

  2. Compound clear cell sarcoma misdiagnosed as a Spitz nevus.

    PubMed

    Kiuru, Maija; Hameed, Meera; Busam, Klaus J

    2013-11-01

    Clear cell sarcoma (CCS) typically presents as a tumor in the deep soft tissue of extremities, but when centered in the dermis it may be confused with a melanocytic nevus, primary nodular or metastatic melanoma. Compound variants of CCS, i.e. tumor cells present in both the epidermis and underlying soft tissue have not yet been described. Herein we report such a case, which initially presented as a nodule on the left wrist of a young woman at 19 years of age. The lesion was then interpreted as 'Spitz nevus, compound type'. Twelve years later the patient noticed an enlarged lymph node in the right axilla. The excised lymph node was nearly completely replaced by malignant tumor cells, which were immunoreactive for S100 protein. They resembled the tumor cells of the wrist lesion. Cytogenetic analysis of the metastatic tumor revealed a t(12;22) translocation. Fluorescence in situ hybridization confirmed Ewing's sarcoma breakpoint region 1 (EWSR1) rearrangement in 70% of the tumor cells, thereby supporting the diagnosis of metastatic CCS. Our case is of interest because it documents that CCS can involve the epidermis. This observation expands the morphological spectrum associated with this tumor. PMID:23980901

  3. Nodular mucinosis misdiagnosed as non-responsive secondary syphilis.

    PubMed

    Patrício, Catarina; Campos, Sara; João, Alexandre; Serrão, Vasco

    2015-01-01

    A previously healthy 24-year-old man presented with an erythematous, non-pruritic and painless papulonodular skin rash affecting the trunk, upper arms (excluding palms), neck, face, forehead and scalp. He had a penile ulcer for the past 2 weeks, almost healed at the time of observation. The patient tested positive for syphilis and HIV-1; he claimed being negative for HIV 6 months earlier. As the palms were not affected, we performed a skin biopsy for the differential diagnosis between secondary lues and acute HIV seroconversion reaction. Benzathine penicillin (2,400,000 units) was administrated and antiretroviral therapy started. Although the skin biopsy was compatible with secondary syphilis, there was no change in the skin rash 3 weeks after the first penicillin administration. Another 2 doses of penicillin were given but 4 weeks later the rash persisted. A second biopsy revealed a mucinous skin infiltration, compatible with nodular mucinosis. PMID:26311009

  4. Nocturnal choking episodes: under-recognized and misdiagnosed.

    PubMed

    Elkay, Muruvet; Poduri, Annapurna; Prabhu, Sanjay P; Bergin, Ann M; Kothare, Sanjeev V

    2010-11-01

    Causes of nocturnal paroxysmal events include a variety of disorders such as epileptic seizures, parasomnias, sleep-related movement disorders, and psychiatric disturbances. Timing and semiology of the events, simultaneous video-electroencephalographic observation, presence of any daytime events, and relevant psychiatric and medical history may help in sorting out various possibilities considered in the differential diagnosis of such events. Timely diagnosis of these events is crucial for appropriate management; under-recognition and misdiagnosis of nonepileptic events is not uncommon. Described here are two cases within the spectrum of nocturnal paroxysmal events, one with nocturnal panic attacks and the other with frontal lobe epilepsy, each presenting with choking episodes. PMID:20933181

  5. Retained lipiodized oil misdiagnosed as residual metallic material.

    PubMed

    Wakabayashi, Yukari; Hashimura, Naohiko; Kubouchi, Takeo

    2004-01-01

    Retained foreign material is one of the most common issues in medical malpractice lawsuits. We report here a case in which an extremely high-density material was found within the pelvis, which proved to be harmless residual lipiodized oil. Although there have been reports of lipiodized oil being retained within the fallopian tube for more than 25 years, to our knowledge there have been no previous reports of lipiodized oil retention in areas other than the genital tract. PMID:15553019

  6. A misdiagnosed burn: necrotising fasciitis in an elderly patient.

    PubMed

    Vijayan, Roshan; Magdum, Ashish; Critchley, Paul

    2013-01-01

    A 91-year-old man was admitted having been found unresponsive in his bed. He was previously well, but had sustained a laceration over the dorsum of his forearm after a recent fall. Initial appearances were innocuous, and suggestive of a superficial wound infection. A review of the wound by the plastic surgeons led to the diagnosis of a full-thickness burn, despite a lack of supporting evidence in the history. No clinician who had initially assessed the patient was involved in his ongoing care. Rapid clinical deterioration ensued, with sepsis and deteriorating mental state. Necrosis spread rapidly up his arm, and the diagnosis of necrotising fasciitis was made. The patient was urgently taken to theatre for circumferential excision of the necrotic tissue. He was subsequently managed on the intensive care unit where he made a promising initial recovery, but later died from pneumonia in the ward. PMID:23833100

  7. Misdiagnosing Dizzy Patients: Common Pitfalls in Clinical Practice.

    PubMed

    Kerber, Kevin A; Newman-Toker, David E

    2015-08-01

    This article highlights 5 pitfalls in the diagnosis of common vestibular disorders: (1) overreliance on dizziness symptom type to drive diagnostic inquiry; (2) underuse and misuse of timing and triggers to categorize patients; (3) underuse, misuse, and misconceptions linked to hallmark eye examination findings; (4) overweighting age, vascular risk factors, and neuroexamination to screen for stroke; and (5) overuse and overreliance on head computed tomography to rule out neurologic causes. This article discusses the evidence base describing each pitfall's frequency and likely causes, and potential alternative strategies that might be used to improve diagnostic accuracy or mitigate harms. PMID:26231272

  8. A Case of Intestinal Mastocytosis Misdiagnosed as Crohn's Disease

    PubMed Central

    Reggiani, Stefania; Cosso, Loretta; Adriani, Alessandro; Pantaleoni, Stefano; Risso, Alessandro; Vittone, Federico; Chiusa, Luigi; Sapone, Nicoletta; Astegiano, Marco

    2015-01-01

    Systemic mastocytosis (SM) is a rare, heterogeneous and progressive disease, characterized by the accumulation of atypical mast cells in various organs, including the gastrointestinal tract. Gastrointestinal symptoms are present in up to 80% of patients with SM, the most common being abdominal pain, diarrhea, nausea and vomiting. Up to 50% of patients with SM do not have classical skin lesions at presentation, and in these patients the diagnosis of SM can be difficult for years. Here we report a case of SM that initially mimicked inflammatory bowel disease, although the patient showed poor response to steroid therapy. The right diagnosis was made only on the surgical specimen obtained after emergency surgery for intestinal obstruction. SM should therefore be considered in the diagnostic approach in patients with gastrointestinal symptoms not attributable to other pathologies and in cases of suspected inflammatory bowel disease with unusual course. PMID:26120300

  9. Bilateral acute iris transillumination (BAIT) initially misdiagnosed as acute iridocyclitis.

    PubMed

    Gonul, Saban; Bozkurt, Banu

    2015-01-01

    Bilateral acute iris transillumination (BAIT) is a relatively new clinical entity characterized by bilateral acute loss of iris pigment epithelium, iris transillumination, pigment dispersion in the anterior chamber, and sphincter paralysis. We report the case of a 30-year-old male who was initially diagnosed with acute iridocyclitis in a different clinic and treated with topical and systemic corticosteroids. He was referred to our clinic to seek another opinion because his symptoms did not improve. An ocular examination revealed bilateral pigment dispersion into the anterior chamber, diffuse iris transillumination, pigment dusting on the anterior lens capsule, atonic and distorted pupils, and increased intraocular pressure, suggesting a diagnosis of BAIT rather than iridocyclitis. Clinicians should be aware of the differential diagnosis of syndromes associated with pigment dispersion from iridocyclitis to avoid aggressive anti-inflammatory therapy and detailed investigation for uveitis. PMID:25945534

  10. Renal amyloidosis due to familial mediterranean fever misdiagnosed

    PubMed Central

    Hama, Iman; Ilham, Ratbi; Ouzeddoun, Naima; Alhamany, Zaitouna; Bayahia, Radia; Sefiani, Abdelaziz

    2012-01-01

    Familial Mediterranean fever (FMF, MIM 249100) is an autosomal recessive disease affecting mainly patients of the Mediterranean basin. It is an autoinflammatory periodic disorder characterized by recurrent episodes of fever and abdominal pain, synovitis, and pleuritis. The major complication of FMF is the development of renal AA amyloidosis. Treatment with colchicine prevents the occurrence of recurrent seizures and renal amyloidosis. The disease is caused by mutations in the MEFV gene. We report here the cases of two unrelated patients, who have been late diagnosed with FMF complicated by renal amyloidosis. We focus on the importance of early diagnosis of FMF, both to start rapidly treatment with colchicine and avoid renal amyloidosis, and to provide genetic counseling to families. PMID:23716950

  11. A laryngeal foreign body misdiagnosed as asthma bronchiale.

    PubMed

    Cinar, Ugur; Vural, Cetin; Turgut, Suat

    2003-12-01

    Laryngotracheal foreign bodies, although less common than bronchial foreign bodies, are potentially more dangerous. We report a 10-year-old girl with Down syndrome with asthma bronchiale symptoms, which was later found to be the result of a thin bone lamella impacted in her larynx. There was no clear history of foreign body aspiration. She was treated with the initial diagnosis of asthma bronchiale. It took a month before the final diagnosis was made. The foreign body was removed via direct laryngoscopy. It was a white and thin bone lamella with sharp edges, measuring 28 x 19 x 2 mm. We thought the case was worth presenting because of its rare location, the size of the foreign body, and the long duration before the final diagnosis was made. PMID:14676516

  12. Was it epilepsy?: misdiagnosing Emily Dickinson (1830-1886).

    PubMed

    Hirschhorn, Norbert; Longsworth, Polly

    2013-01-01

    Lyndall Gordon's recent biography, Lives Like Loaded Guns: Emily Dickinson and Her Family's Feuds (2010), tells with high verve the story of generational infighting over poet Emily Dickinson's posthumous presentation to the world. Equally dramatic is Gordon's hypothesis that Dickinson suffered from epilepsy, which led Gordon to seemingly solve the ineffable mystery of Dickinson's reclusion, a conundrum in her own time and still so in ours. Gordon's startling diagnosis has been commended by book reviewers and on talk shows. Her hypothesis is based on two lines of inquiry. First, she avers that a compound called glycerine, which Dickinson took regularly in the early 1850s, was an anti-epileptic, basing this notion on its presence in a mixture containing the soporific chloral hydrate, a prescription first advised for epilepsy some two decades later. Second, Gordon proposes a genetic strain of epilepsy in the Dickinson family. In the process, Gordon recruits Dickinson's various illnesses to her hypothesis. This article refutes Gordon's claims on scientific, clinical, and biographical grounds. It reviews Dickinson's medical history to establish a differential diagnosis, in which epilepsy is considered and rejected. PMID:24375119

  13. Congenital chloride diarrhea misdiagnosed as pseudo-Bartter syndrome.

    PubMed

    Saneian, Hossein; Bahraminia, Emad

    2013-09-01

    Congenital chloride diarrhea (CCD) is a rare autosomal recessive disease which is characterized by intractable diarrhea of infancy, failure to thrive, high fecal chloride, hypochloremia, hypokalemia, hyponatremia and metabolic alkalosis. In this case report, we present the first female and the second official case of CCD in Iran. A 15-month-old girl referred to our hospital due to failure to thrive and poor feeding. She had normal kidneys, liver and spleen. Treating her with Shohl's solution, thiazide and zinc sulfate did not result in weight gain. Consequently, pseudo-Bartter syndrome was suspected, she was treated with intravenous (IV) therapy to which she responded dramatically. In addition, hypokalemia resolved quickly. Since this does not usually happen in patients with the pseudo-Bartter syndrome, stool tests were performed. Abnormal level of chloride in stool suggested CCD and she was thus treated with IV fluid replacement, Total parentral nutrition and high dose of oral omeprazole (3 mg/kg/day). She gained 1 kg of weight and is doing fine until present. CCD is a rare hereditary cause of intractable diarrhea of infancy. It should be considered in infants with unknown severe electrolyte disturbances. PMID:24381629

  14. Massive nodular pseudoangiomatous stromal hyperplasia (PASH) of the breast arising simultaneously in the axilla and vulva.

    PubMed

    Jordan, Adrienne C; Jaffer, Shabnam; Mercer, Stephen E

    2011-02-01

    The authors describe a 52-year-old woman with a history of bilateral mastectomies for macromastia caused by massive nodular pseudoangiomatous stromal hyperplasia (PASH), who presented with 2 large growths in her left axilla and groin. These masses had been increasing in size for nearly a year. When excised, the axillary mass had dimensions of 14.0 × 14.0 × 5.5 cm(3) and weighed 664 g. The groin mass was slightly smaller at 14.5 × 11.0 × 5.0 cm(3) and 518 g. Microscopic examination of both masses revealed breast tissue expanded by a hyalinized stroma with prominent slit-like pseudovascular spaces, consistent with PASH. Small incidental foci of PASH are common findings in breast excisions; however, large nodular foci are rare. Furthermore, nodular foci in accessory breast tissue are exceedingly rarer and can raise clinical concerns for malignancy. Histopathologically, PASH can be mistaken for low-grade angiosarcoma. To the authors' knowledge, the present case appears to be the first description of multiple simultaneous foci of massive nodular PASH arising in accessory breast tissue. PMID:21285079

  15. Chemoradiotherapy in a Case of Malignant Syringocystadenocarcinoma Papilliferum of Vulva with Locoregional Failure

    PubMed Central

    Rao, Pamidimukkala Bramhananda; Ghosh, Saptarshi; Mohapatra, Manisha; Philip, N. Pramod; Kumar, P. Ravindra; Manam, Surendra; Karra, Pradeep; Jasti, Vijay Krishna

    2015-01-01

    Introduction. Syringocystadenocarcinoma papilliferum (SCACP) is an extremely rare malignant adnexal tumor, which arises from syringocystadenoma papilliferum. To date, less than 30 cases of malignant SCACP have been reported, of which locoregional metastases were found in only four cases. Case Report. A 57-year-old female patient who presented to our Oncology Department with a recurrent malignant SCACP of the left labia along with right inguinal lymphadenopathy. Pathological examination confirmed the diagnosis of malignant SCACP with right inguinal lymph node metastases. Due to the fixity of the right inguinal nodes, neoadjuvant chemotherapy was administered with Cisplatin and 5-Fluorouracil for four cycles, following which the primary tumor and the contralateral inguinal nodes regressed completely. Then definitive chemoradiation was delivered with five cycles of weekly Cisplatin and external beam pelvic irradiation up to a dose of 59.4 Gy. Patient is disease-free 11 months after treatment. Discussion. We here report the fifth case of malignant SCACP with locoregional metastases. This is the first case of malignant SCACP which has been treated with neoadjuvant chemotherapy followed by concurrent chemoradiation. Although surgery has been used most commonly, chemoradiation may also have a role in the treatment of malignant SCACP, especially in cases of locoregional metastases. PMID:26697249

  16. Primary mucinous adenocarcinoma of the vulva: A case report and review of the literature

    PubMed Central

    SUI, YANXIA; ZOU, JUNKAI; BATCHU, NASRA; LV, SHULAN; SUN, CHAO; DU, JIANG; WANG, QING; SONG, QING; LI, QILING

    2016-01-01

    Primary vulvar cancer is a rare disease with an incidence of 2–3 per 100,000 women. The vast majority of vulvar carcinomas are of the squamous cell type (90%). Primary vulvar adenocarcinomas rank among the rare gynecological malignancies. We herein present a case of a vulvar mass near the vaginal orifice, the biopsy of which revealed a mucinous adenocarcinoma. Local excision was performed, followed by postoperative chemotherapy. The patient was asymptomatic and developed no recurrence during the 2 years of follow-up after surgery and chemotherapy. We consider local excision, with or without chemotherapy, to be an effective therapeutic approach to this type of tumor. However, further studies are required to support our conclusions for early-stage vulvar mucinous adenocarcinoma.

  17. Velvet Vulvas at School: The Catalyzing Power of the Arts in Education

    ERIC Educational Resources Information Center

    Quinn, Therese

    2008-01-01

    As a teacher of art teachers, this author values and promotes an education through the arts that loves freedom, an education through art connected to powerful social ideas and movements, connected to social justice. This is not a kind of education common today in public schools, but it has a rich lineage. Drawing inspiration from Maxine Greene,…

  18. Aggressive angiomyxoma of vulva in a 13-year-old female.

    PubMed

    Srivastava, Pooja; Ahluwalia, Charanjeet; Zaheer, Sufian; Mandal, Ashish Kumar

    2015-01-01

    Aggressive angiomyxoma is a rare mesenchymal neoplasm that typically affects females of reproductive age. It involves preferentially pelvic and perineal regions and was first described by Steeper and Rosai in 1983. Peak age of incidence for this tumor is in the fourth decade with very few cases reported in young girls. We present a case of this rare tumor in a 13-year-old female. PMID:26881549

  19. Squamous precursor lesions of the vulva: current classification and diagnostic challenges.

    PubMed

    Hoang, Lien N; Park, Kay J; Soslow, Robert A; Murali, Rajmohan

    2016-06-01

    Growing evidence has established two major types of vulvar intraepithelial neoplasia (VIN), which correspond to two distinct oncogenic pathways to vulvar squamous cell carcinoma (VSCC). While the incidence of VSCC has remained relatively stable over the last three decades, the incidence of VIN has increased. VIN of usual type (uVIN) is human papillomavirus (HPV)-driven, affects younger women and is a multicentric disease. In contrast, VIN of differentiated type (dVIN) occurs in post-menopausal women and develops independent of HPV infection. dVIN often arises in a background of lichen sclerosus and chronic inflammatory dermatoses. Although isolated dVIN is significantly less common than uVIN, dVIN bears a greater risk for malignant transformation to VSCC and progresses over a shorter time interval. On histological examination, uVIN displays conspicuous architectural and cytological abnormalities, while the morphological features that characterise dVIN are much more subtle and raise a wide differential diagnosis. On the molecular level, dVIN is characterised by a higher number of somatic mutations, particularly in TP53. Here we review the classification, epidemiology, clinical features, histomorphology, ancillary markers and molecular genetics of both types of VIN, and discuss the morphological challenges faced by pathologists in interpreting these lesions. PMID:27113549

  20. [Burning Vulva: Significance of Surgery in Inflammatory and Precancerous Vulvar Pathologies].

    PubMed

    Ghisu, Gian-Piero; Fink, Daniel

    2015-06-17

    Vuval pathologies manifested by allodynia and burning sensations can be due to infection, inflammatory dermatoses or other causes. Infective as well as certain inflammatory diseases, e.g. drug eruptions, allergic eczemas, irritative dermatitis/vulvitis, Behcet's Syndrome and pemphigus/pemphigoid usually respond well to conservative treatment. The category of inflammatory diseases also contains pathologies that in certain circumstances do require a surgical intervention, e.g. Lichen ruber planus/Lichen sclerosus, Condyloma, scars, premalignant lesions (VIN, genital M. Paget) and cancer. Vulodynia also can cause some stinging to the vulvar skin. The surgical aspects relating to the treatment of the benign and premalignant pathologies indicated above are mentioned in this mini-review. PMID:26081381

  1. Misdiagnosed male breast cancer with an unknown primary tumor: A case report

    PubMed Central

    WANG, WEN-WU; CHEN, LANG; OUYANG, XUE-NONG

    2014-01-01

    Compared with female breast cancer, male breast cancer (MBC) has an extremely low morbidity, later staging and fewer breast tissues. The lumps are easier to invade in the center and the majority of the cases are positive for metastatic lymph node, with the typical clinical manifestation as a painless mass in partial breast. MBC with an unknown primary tumor is rare and is often prone to misdiagnosis, resulting in a delay in correct treatment. Such a case is extremely significant for clinical reference. The current study presents a 58-year-old male who developed a painless mass in the left armpit and received armpit mass biopsy and pathological examination which showed glandular cancer, with a high possibility of mammary primary tumor. The patient was administered four cycles of paclitaxel plus oxaliplatin chemotherapy. However, three months later, the patient identified novel disseminated lymph nodes in the left armpit. The initial pathological section and paraffin blocks were re-examined and the patient was finally diagnosed with breast invasive ductal carcinoma based on the metastases pathology and immunohistochemical examination. No breast mass was found on physical examination of the patient and the tumor markers, including cancer antigen 125 and carcinoembryonic antigen, were normal. No primary tumors were observed in the mammography and PET-CT and the primary tumor was not found following the left breast modified radical mastectomy. PMID:24959243

  2. [Misdiagnosed PTSD and zeldox pharmacotherapy in case of a political prisoner].

    PubMed

    Frecska, Ede; Keresztes, Mária; Gaszner, Gábor

    2004-12-01

    Treatment of survivors of political terror is an emerging and difficult field. Reports on posttraumatic stress disorder (PTSD) in political prisoners within the former Eastern Block countries is low and mostly restricted to German sources. During the totalitarian period administrative and clinical decisions often had to take into account political realities not found in other treatment environments. That practice might have lead to biased professional training, lack of experience extending into the post-communist era and leading to current underpresentation of PTSD. The authors present a case report of a Hungarian political prisoner with long history of PTSD who had a "carry over" diagnosis of paranoid schizophrenia even 15 years after the collapse of the communist regime. After decades of continuous administration of antipsychotic and antidepressive medications, either alone or in combination, Zeldox monotherapy has proven to be the most effective treatment for this patient. PMID:15825678

  3. Primary Cutaneous Leiomyosarcoma in a Young Patient Previously Misdiagnosed as Pleomorphic Fibroma

    PubMed Central

    Abbasi, Fariba; Mahmudlu, Rahim; Nikniaz, Yasaman; Rezaie, Makan

    2015-01-01

    Cutaneous leiomyosarcoma is a relatively rare tumor accounts for about 2-3% of superficial soft tissue sarcomas. It occurs more frequently in males in fifth and sixth decades with a predilection for extremities. We report a 27 years old male with cutaneous leiomyosarcoma of thigh, previously diagnosed as pleomorphicfibroma. The tumor composed of pleomorphic spindle shaped cells with blunt ended nuclei and high mitotic activity. Smooth muscle actin was positive. In this case, the young age of the patient and previous misdiagnosis of the tumor are interesting. Subtle histologic features of low grade leiomyosarcoma can be a pitfall in diagnosis and so affects the optimal management of the patient as it occurred in previous sample of this case. PMID:26516329

  4. Primary renal carcinoid tumour with lung metastasis misdiagnosed as renal cell carcinoma.

    PubMed

    Daboul, Nour; Monga, Dulabh; Bunker, Mark

    2016-01-01

    A 58-year-old man with a history of metastatic renal cell carcinoma (RCC) diagnosed 10 years prior, status post right nephrectomy, presented for evaluation of pulmonary nodules. A year after the nephrectomy, he had undergone cutaneous metastasectomy in the right flank area, and a further 2 years later he had had his second cutaneous metastasectomy in the right chest wall. Both cutaneous pathologies had, at the time, shown metastatic neoplasm with histological features compatible with those of the previous renal tumour. He was treated with sorafenib. 3 years later he developed asymptomatic pulmonary nodules, which gradually doubled in size over the next 2.5 years. He underwent bronchoscopy and left lower lobe biopsy. Pathology revealed a metastatic renal carcinoid/neuroendocrine tumour. Second review of the previous renal neoplasm and the cutaneous metastatic pathology showed trabecular architecture, consistent with carcinoid, but mimicking the long parallel arrays that have been described in some cases of papillary RCC. PMID:26951438

  5. Child abuse and osteogenesis imperfecta: how can they be still misdiagnosed? A case report

    PubMed Central

    D’Eufemia, Patrizia; Palombaro, Marta; Lodato, Valentina; Zambrano, Anna; Celli, Mauro; Persiani, Pietro; De Bari, Maria Pia; Sangiorgi, Luca

    2012-01-01

    Summary Osteogenesis imperfecta (OI) is a rare hereditary disease caused by mutations in genes coding for type I collagen, resulting in bone fragility. In literature are described forms lethal in perinatal period, forms which are moderate and slight forms where the only sign of disease is osteopenia. Child abuse is an important social and medical problem. Fractures are the second most common presentation after skin lesions and may present specific patterns. The differential diagnosis between slight-moderate forms of OI and child abuse could be very challenging especially when other signs typical of abuse are absent, since both could present with multiple fractures without reasonable explanations. We report a 20 months-old female with a history of 4 fractures occurred between the age of three and eighteen months, brought to authorities’ attention as a suspected child abuse. However when she came to our department physical examination, biochemical tests, total body X-ray and a molecular analysis of DNA led the diagnosis of OI. Thus, a treatment with bisphosphonate and a physical rehabilitation process, according to Vojta method, were started with improvement in bony mineralization, gross motor skills and absence of new fracture. In conclusion our case demonstrates how in any child presenting fractures efforts should be made to consider, besides child abuse, all the other hypothesis even the rarest as OI. PMID:23289038

  6. Child abuse and osteogenesis imperfecta: how can they be still misdiagnosed? A case report.

    PubMed

    D'Eufemia, Patrizia; Palombaro, Marta; Lodato, Valentina; Zambrano, Anna; Celli, Mauro; Persiani, Pietro; De Bari, Maria Pia; Sangiorgi, Luca

    2012-09-01

    Osteogenesis imperfecta (OI) is a rare hereditary disease caused by mutations in genes coding for type I collagen, resulting in bone fragility. In literature are described forms lethal in perinatal period, forms which are moderate and slight forms where the only sign of disease is osteopenia. Child abuse is an important social and medical problem. Fractures are the second most common presentation after skin lesions and may present specific patterns.The differential diagnosis between slight-moderate forms of OI and child abuse could be very challenging especially when other signs typical of abuse are absent, since both could present with multiple fractures without reasonable explanations. We report a 20 months-old female with a history of 4 fractures occurred between the age of three and eighteen months, brought to authorities' attention as a suspected child abuse.However when she came to our department physical examination, biochemical tests, total body X-ray and a molecular analysis of DNA led the diagnosis of OI.Thus, a treatment with bisphosphonate and a physical rehabilitation process, according to Vojta method, were started with improvement in bony mineralization, gross motor skills and absence of new fracture.In conclusion our case demonstrates how in any child presenting fractures efforts should be made to consider, besides child abuse, all the other hypothesis even the rarest as OI. PMID:23289038

  7. Solid Pseudopapillary Tumor of the Pancreas: a rare and probably misdiagnosed neoplasm

    PubMed Central

    Vilaa, Ana Frias; Rodrigues, Pedro; Scigliano, Horcio; Pinto, Joana; Reis, Alcinda

    2011-01-01

    Solid Pseudopapillary Tumor of the pancreas is a rare nonfunctioning tumor. It is considered a low-grade malignancy that is apparently curable with surgical complete excision in most instances. We present a case of solid pseudopapillary pancreatic tumor that represented a challenge to the radiologists. This case highlights its possible various appearances and the need to the radiologist to be familiar with them. PMID:22470804

  8. Mesothelial Cyst of the Round Ligament Misdiagnosed as Irreducible Inguinal Hernia

    PubMed Central

    Manatakis, Dimitrios K.; Stamos, Nikolaos; Agalianos, Christos; Vamvakas, Panagiotis; Kordelas, Athanasios; Davides, Demetrios

    2013-01-01

    We report the case of a 36-year-old woman who presented with signs and symptoms of an irreducible inguinal hernia. Surgical exploration revealed a mesothelial cyst of the round ligament of the uterus. Mesothelial cysts of the round ligament are rare lesions, frequently masquerading as inguinal hernias, and should be included in the differential diagnosis of any inguinal mass. Clinical findings are those of a groin mass, discomfort, and bulging. Ultrasound and CT scans often demonstrate an aperistaltic cystic mass. Definitive diagnosis is usually made intraoperatively and confirmed histopathologically. PMID:24159409

  9. Dysembryoplastic neuroepithelial tumor: A rare brain tumor not to be misdiagnosed

    PubMed Central

    Sukheeja, Deepti; Mehta, Jayanti

    2016-01-01

    Dysembryoplastic neuroepithelial tumor (DNET) is a recently described, morphologically unique, and surgically curable low-grade brain tumor which is included in the latest WHO classification as neuronal and mixed neuronal-glial tumor. It is usually seen in children and young adults. The importance of this particular entity is that it is a surgically curable neuroepithelial neoplasm. When recognized, the need for adjuvant radiotherapy and chemotherapy is obviated. We hereby present a case report of an 8-year-old male child who presented with intractable seizures and parieto-occipital space occupying lesion. Histologically, the tumor exhibited features of WHO grade I dysembryoplastic neuroepithelial tumor which was further confirmed by immunohistochemistry. PMID:27057233

  10. Gastric schwannoma misdiagnosed as GIST: A case report with immunohistochemical and molecular study

    PubMed Central

    TATANGELO, FABIANA; CANTILE, MONICA; COLLINA, FRANCESCA; BELLI, ANDREA; DE FRANCISCIS, SILVIA; BIANCO, FRANCO; BOTTI, GERARDO

    2016-01-01

    Schwannomas are tumors derived from Schwann cells. Generally, they are benign and their typical site of origin is the subcutaneous tissue of the distal extremities or of the head and neck region. Gastrointestinal localization of schwannomas is extremely rare, and the stomach is the prevalent site. The present study describes the case of a gastric schwannoma in a 61-year-old male who underwent subtotal gastrectomy following a clinical diagnosis of a gastrointestinal stromal tumor (GIST). A histological, immunohistochemical and molecular study was performed to exclude the misdiagnosis of GIST. The histomorphological features of the lesion and absence of c-Kit and PDGFRA mutations indicated the diagnosis of gastric schwannoma. PMID:27073505

  11. Insufficiency fractures of the distal tibia misdiagnosed as cellulitis in three patients with rheumatoid arthritis

    SciTech Connect

    Straaton, K.V.; Lopez-Mendez, A.; Alarcon, G.S. )

    1991-07-01

    We describe 3 patients with rheumatoid arthritis who presented with diffuse pain, swelling, and erythema of the distal aspect of the lower extremity, suggestive of either cellulitis or thrombophlebitis, but were found to have insufficiency fractures of the distal tibia. The value of technetium-99m diphosphonate bone scintigraphy in the early recognition of these fractures and a possible explanation for the associated inflammatory symptoms are discussed.

  12. Chlamydial Proctitis in a Young Man Who Has Sex with Men: Misdiagnosed as Inflammatory Bowel Disease

    PubMed Central

    Lee, Kyung Jin; Shin, Dong Hwan; Jung, Jun Oh; Koh, Seokyoung; Kim, Ka Young; Lee, Jae Min

    2015-01-01

    We report the case of a 20-year-old man with a 2-month history of anal pain and bloody rectal discharge. He was referred to our clinic of gastroenterology for suspected inflammatory bowel disease (IBD). The colonoscopy showed mucosal nodularities on the rectum and an anal tag. Because the colonoscopic findings were not consistent with the typical manifestations of IBD, we took an additional sexual history and performed studies for infectious proctitis, including serologic tests for Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum. He had homosexual experience, and the serologic tests and PCR of a rectal swab were positive for C. trachomatis infection. Finally he was diagnosed as having chlamydial proctitis and was treated with intramuscular ceftriaxone 250 mg in a single dose and doxycycline 100 mg orally twice daily for 7 days. After 2 months, he had no lower abdominal symptoms and his endoscopic findings were improved. PMID:26730366

  13. Local recurrent vaginal aggressive angiomyxoma misdiagnosed as cellular angiomyofibroblastoma: A case report

    PubMed Central

    WANG, YIN-FENG; QIAN, HONG-LANG; JIN, HANG-MEI

    2016-01-01

    Aggressive angiomyxoma (AAM) and angiomyofibroblastoma (AMFB) are two rare types of mesenchymal tumors with overlapping clinicopathological features. In certain cases, the differential diagnosis between the two tumors is difficult even for experienced pathologists. The present study reported the case of a well-circumscribed soft tissue mass on the anterior wall of the vagina in a 25-year-old woman. The mass was initially removed without disturbance to the adjacent tissues. The histopathological features included spindle cells in inconspicuous myxoid stroma and a well-demarcated mass without evidence of invasion, which prompted the initial diagnosis of AMFB. After 2 years, a mass returned in the same area and a wide tumor excision was performed. The histopathological examination confirmed the final diagnosis of AAM upon review. PMID:27168823

  14. Tibial torus and toddler's fractures misdiagnosed as transient synovitis: a case series

    PubMed Central

    2011-01-01

    Introduction The high incidence of transient synovitis in early childhood makes it the first suspected pathology in a limping child. Trauma, which has long been regarded as a causative factor for transient synovitis, may be underestimated in a non-cooperative toddler. After excluding most serious conditions, such as septic arthritis, a speculative diagnosis of transient synovitis can be made, and this can easily mask a subtle musculoskeletal injury. Case presentations We report the cases of three Caucasian patients (two boys, aged 20-months- and three-years-old, and one girl, aged two-years-old), with tibial torus and toddler's fractures which were late-diagnosed due to an initial misdiagnosis of transient synovitis of the hip. Conclusion In a non-cooperative child musculoskeletal trauma can be mistaken as a simple causative factor for transient synovitis of the hip and this can easily prevent further investigation for a possible subtle musculoskeletal injury of the lower extremities. Our experience with the presented cases suggests the need to be more vigilant in the differential diagnosis of transient synovitis in young children. PMID:21752248

  15. "Why do I always see double?" A misdiagnosed case of ocular myasthenia gravis for 10 years.

    PubMed

    Yousuf, Uduman Ali Mohamed; Yashodhara, B M; Thanigasalam, Thevi; Ting, Heng Siang

    2014-01-01

    A 58-year-old man presented with diplopia and partial ptosis for 10 years. It was non-progressive in nature, despite inadequate medical attention the patient received from non-specialists/general practitioners. He did not have fatigability or diurnal variation in weakness and was clinically stable without exacerbations of disease for a decade. He did not have features of Graves's disease, oculopharyngeal dystrophy, cranial nerve paralysis, polymyositis and stroke. The possibility of an atypical presentation of myasthenia gravis (MG) was considered and the patient was evaluated. Ice pack test was negative, Cogan's lid twitch (CLT) test was positive and high titres of acetylcholine receptor antibodies (AChR Ab) suggestive of MG were found. He was treated accordingly with a very good response. PMID:24792021

  16. Acute intermittent porphyria caused by novel mutation in HMBS gene, misdiagnosed as cholecystitis

    PubMed Central

    Alfadhel, Majid; Saleh, Neam; Alenazi, Helal; Baffoe-Bonnie, Henry

    2014-01-01

    Background Acute intermittent porphyria (AIP) is an autosomal dominant neurovisceral inherited disorder due to a defect in the heme biosynthesis pathway. Misdiagnosis of the porphyrias is not uncommon. Case report We present a case of a 26-year-old female with suspected acute cholecystitis, mental status changes, and seizures. Biochemical and molecular investigations confirmed the diagnosis of AIP by findings of elevated urinary porphobilinogen, 5-aminolevulinic acid, and total porphyrins. DNA molecular testing showed a novel heterozygous mutation (c. 760delC p.L254X) in the exon11 of the HMBS gene. To the best of our knowledge, this is the first report of a misdiagnosis of AIP presenting with acute cholecystitis. Conclusion Clinicians are alerted to consider the possibility of AIP in an adult presenting with an acute abdomen, features of cholecystitis, and neuropsychiatric manifestations. PMID:25419136

  17. Vertebral Arteriovenous Fistula Associated with Neurofibromatosis Type I Misdiagnosed as a Giant Aneurysm *

    PubMed Central

    Benndorf, G.; Assmann, U.; Bender, A.; Lehmann, T. N.; Lanksch, W. R.

    2000-01-01

    Summary A 59-year-old man with neurofibromatosis type 1 (NF1) presented with bruits and neck pain due to a space occupying lesion in the right neck tissue. Digital subtraction angiography (DSA) showed an arteriovenous fistula (AVF) of the right extracranial vertebral artery (VA) with a giant venous pouch and an intracranial berry aneurysm of the right middle cerebral artery (MCA). First, the MCA aneurysm was surgically clipped, then the patient was treated by embolisation with coils. The coils were placed transarterially from the left VA resulting in a partial thrombosis of the venous pouch. Complete closure was achieved secondarily by retrograde transvenous catheterization. Etiology and treatment modalities are discussed. PMID:20667184

  18. Primary Hyperparathyroidism Misdiagnosed as Giant Cell Bone Tumor of Maxillary Sinus: A Case Report

    PubMed Central

    Aghaghazvini, Leila; Sharifian, Hashem; Rasuli, Bahman

    2016-01-01

    Primary hyperparathyroidism is an endocrine disorder recognized by hyperfunction of parathyroid gland, which can result in persistent bone absorption and brown tumor. Facial involvement of brown tumor is rare and usually involves the mandible. Giant cell tumor ( GCT) is an expansile osteolytic bone tumor which is very similar in clinical, radiological and histological features to brown tumor. Herein, we present a 35-year-old woman with an 11-month history of gradually swelling of the right maxilla and buccal spaces began during pregnancy two years ago. No other clinical or laboratory problems were detected. Postpartum CT scan demonstrated a lytic expansile multi-septated mass lesion containing enhancing areas, which initially described as GCT of the right maxillary sinus following surgery. Four months later, gradual progressive swelling of the bed of tumor was recurred and revised pathological slices were compatible with GCT. Regarding patient recent paresthesia, repeated laboratory tests were performed. Finally, according to laboratory results (elevation of serum calcium and parathyroid hormone), ultrasonographic findings and radioisotope scan (Sestamibi), probable parathyroid mass and brown tumor of maxilla was diagnosed. Pathology confirmed hyperplasia of right inferior parathyroid gland. Our case was thought-provoking due to its interesting clinical presentation and unusual presentation of brown tumor in parathyroid hyperplasia. PMID:27127572

  19. Infantile fibrosarcoma of ethmoid sinus, misdiagnosed as an adenoid in a 5-year-old child

    PubMed Central

    Geramizadeh, Bita; Khademi, Bijan; Karimi, Mehran; Shekarkhar, Golsa

    2015-01-01

    Infantile fibrosarcoma of head and neck is rare and the presence of this tumor in ethmoid sinus is even more uncommon. To the best of our knowledge, <5 cases have been reported in the last 20 years in the English literature, so far, only one of which has been infantile type in a 15 months old girl. In this case report, we will explain our experience with a rare case of infantile fibrosarcoma originating from ethmoid sinus in a 5-year-old boy who presented with dyspnea and epistaxis. After biopsy, it was diagnosed as fibrosarcoma of sinus origin. PMID:26604519

  20. Metastatic pulmonary calcification misdiagnosed as a fungal infection: A case report

    PubMed Central

    LIANG, ZHIXIN; QIU, TIAN; ZHAO, ZHIGANG; CHEN, LIANG'AN; SHE, DANYANG

    2016-01-01

    Metastatic pulmonary calcification is a rare lesion, characterized by calcium salt depositing in normal lung tissue. The clinical profile of a case of metastatic pulmonary calcification following renal transplantation was described. A computed tomography scan of the chest revealed ground-glass opacities in bilateral lungs and a node exhibiting a halo in the right upper lobe, which were suspected aspergillus infection. Following examination and therapy, the results of lung biopsy revealed metastatic pulmonary calcification. Although metastatic pulmonary calcification was reported in renal failure patients previously, metastatic pulmonary calcification with cavity lesions has never, to the best of our knowledge, been previously reported. The aim of the present report was to improve the understanding of metastatic pulmonary calcification. PMID:26998293

  1. Chlamydial Proctitis in a Young Man Who Has Sex with Men: Misdiagnosed as Inflammatory Bowel Disease.

    PubMed

    Lee, Kyung Jin; Kim, Jaeyeon; Shin, Dong Hwan; Jung, Jun Oh; Koh, Seokyoung; Kim, Ka Young; Lee, Jae Min

    2015-12-01

    We report the case of a 20-year-old man with a 2-month history of anal pain and bloody rectal discharge. He was referred to our clinic of gastroenterology for suspected inflammatory bowel disease (IBD). The colonoscopy showed mucosal nodularities on the rectum and an anal tag. Because the colonoscopic findings were not consistent with the typical manifestations of IBD, we took an additional sexual history and performed studies for infectious proctitis, including serologic tests for Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum. He had homosexual experience, and the serologic tests and PCR of a rectal swab were positive for C. trachomatis infection. Finally he was diagnosed as having chlamydial proctitis and was treated with intramuscular ceftriaxone 250 mg in a single dose and doxycycline 100 mg orally twice daily for 7 days. After 2 months, he had no lower abdominal symptoms and his endoscopic findings were improved. PMID:26730366

  2. A case of intradural-extramedullary form of primary spinal cysticercosis misdiagnosed as an arachnoid cyst.

    PubMed

    Yoo, Minwook; Lee, Chang-Hyun; Kim, Ki-Jeong; Kim, Hyun-Jib

    2014-04-01

    We describe a rare case of intradural-extramedullary primary spinal cysticercosis. A 42-year-old man visited our institute for lower back pain. He denied having consumed raw meet. Magnetic resonance (MR) images revealed an intradural pure cystic mass at the L3-L4 level. A radiologic diagnosis of spinal arachnoid cyst was established. Three years later, he complained of aggravated back pain, and follow-up MR examination showed a markedly expanded cyst, occupying the subarachnoid space from the T11 to the S1 level. L2 hemilaminectomy was performed, and a yellowish infected cyst bulged out through the dural opening. The cyst was removed en bloc. The histopathological findings of the cyst were consistent with parasitic infection. Serum enzyme-linked immunosorbent assay (ELISA) confirmed the presence of spinal cysticercosis. As there was no intracranial lesion, the final diagnosis was primary spinal cysticercosis, which is very rare. MR imaging is a sensitive diagnostic tool for detecting cystic lesions in the spine; however, it is difficult to distinguish cysticercosis from non-infectious cysts such as an arachnoid cyst without using gadolinium enhancement. Clinicians treating spinal cysts with an unusual clinical course should include cysticercosis as a differential diagnosis. We recommend contrast-enhanced MR imaging and serum ELISA in the diagnostic work-up of such cases. PMID:25024830

  3. [Malignant meningioma with adenocarcinoma-like metaplasia: a rare entity to be not misdiagnosed].

    PubMed

    Marguet, Florent; Proust, François; Crahes, Marie; Basset, Carole; Joly-Helas, Géraldine; Chambon, Pascal; Laquerrière, Annie

    2014-06-01

    We report on a 51-year-old woman who presented with a cervical spinal cord tumor clinically suspected to be a metastasis. Histological examination revealed an anaplastic meningioma containing epithelial nests arranged in a gland-like pattern suggestive of adenocarcinoma. This component strongly expressed cytokeratins whereas the meningothelial component was vimentin--epithelial membrane antigen--and progesterone receptor-immunoreactive, suggesting either anaplastic meningioma with adenocarcinoma-like metaplasia, or adenocarcinoma metastasis in a meningioma, but the search for a primitive neoplasia including thoracic-abdominal-pelvic computed tomography and mammography was negative. Anaplastic meningiomas with adenocarcinoma-like metaplasia are uncommon lesions, 4 cases having been reported in the literature so far. Their immunohistochemical and chromosomal characteristics are similar to those observed in secretory meningiomas. When available, fluorescence in situ hybridization detects the same chromosomal alterations in the two components, confirming a common clonal origin. This observation demonstrates the necessity to perform the correct diagnosis of malignant meningioma with adenocarcinomatous metaplasia, whose prognosis and treatment radically differ from those of metastatic adenocarcinoma located in a meningioma. PMID:24950872

  4. A foreign body of the larynx misdiagnosed as vocal cord paralysis

    PubMed Central

    Kumar, Sunil; Singh, Devendra Bahadur; Singh, Abhishek Bahadur

    2013-01-01

    Foreign bodies in the aerodigestive tract continue to be a common problem that contribute significantly to high morbidity and mortality all over the world. Laryngeal foreign bodies may present with less severe symptoms compared with lower respiratory tract foreign bodies, resulting in misdiagnosis, confusion and delay in diagnosis. Rigid endoscopy with forceps removal under general anaesthesia is the preferred management modality. This case is described to show the importance of a detailed history and examination including X-ray neck in children to rule out any radiopaque laryngeal foreign body as a delay in diagnosis and management can lead to life-threatening complications. PMID:23853027

  5. Dysembryoplastic neuroepithelial tumor: A rare brain tumor not to be misdiagnosed.

    PubMed

    Sukheeja, Deepti; Mehta, Jayanti

    2016-01-01

    Dysembryoplastic neuroepithelial tumor (DNET) is a recently described, morphologically unique, and surgically curable low-grade brain tumor which is included in the latest WHO classification as neuronal and mixed neuronal-glial tumor. It is usually seen in children and young adults. The importance of this particular entity is that it is a surgically curable neuroepithelial neoplasm. When recognized, the need for adjuvant radiotherapy and chemotherapy is obviated. We hereby present a case report of an 8-year-old male child who presented with intractable seizures and parieto-occipital space occupying lesion. Histologically, the tumor exhibited features of WHO grade I dysembryoplastic neuroepithelial tumor which was further confirmed by immunohistochemistry. PMID:27057233

  6. A case of hepatoblastoma misdiagnosed as combined hepatocellular carcinoma and cholangiocarcinoma in an adult

    PubMed Central

    Park, Keun Woo; Seo, Chang Jin; Yun, Dae Young; Kim, Min Keun; Kim, Byung Seok; Han, Young Seok; Oh, Hoon Kyu

    2015-01-01

    Hepatoblastoma usually occurs in children under the age of 2 years, with very few cases reported in adults. We experienced a case of adult hepatoblastoma in a 36-year-old female with chronic hepatitis B. She had experienced sudden onset abdominal pain. Her serum alpha-fetoprotein level was markedly elevated, and abdominal CT showed a 9-cm mass with internal hemorrhage in the right hepatic lobe with hemoperitoneum, so an emergency hepatic central bisectionectomy was performed. The initial histologic examination revealed that the mass mimicked combined hepatocellular carcinoma and cholangiocarcinoma with spindle-cell metaplasia of the cholangiocarcinoma element. Follow-up abdominal CT performed 3 months later showed a 5.5-cm metastatic mass in the left subphrenic area. Laparoscopic splenectomy with mass excision was performed, and hepatoblastoma was confirmed histologically. A histologic re-examination of previously obtained surgical specimens also confirmed the presence of hepatoblastoma. Metastatic hepatoblastoma was found at multiple sites of the abdomen during follow-up, and so chemotherapy with cisplatin, 5-fluorouracil (5-FU), and vincristine was applied, followed by carboplatin and doxorubicin. Despite surgery and postoperative chemotherapy, she died 12 months after symptom onset. PMID:26523273

  7. A case of hepatoblastoma misdiagnosed as combined hepatocellular carcinoma and cholangiocarcinoma in an adult.

    PubMed

    Park, Keun Woo; Seo, Chang Jin; Yun, Dae Young; Kim, Min Keun; Kim, Byung Seok; Han, Young Seok; Oh, Hoon Kyu; Lee, Chang Hyeong

    2015-09-01

    Hepatoblastoma usually occurs in children under the age of 2 years, with very few cases reported in adults. We experienced a case of adult hepatoblastoma in a 36-year-old female with chronic hepatitis B. She had experienced sudden onset abdominal pain. Her serum alpha-fetoprotein level was markedly elevated, and abdominal CT showed a 9-cm mass with internal hemorrhage in the right hepatic lobe with hemoperitoneum, so an emergency hepatic central bisectionectomy was performed. The initial histologic examination revealed that the mass mimicked combined hepatocellular carcinoma and cholangiocarcinoma with spindle-cell metaplasia of the cholangiocarcinoma element. Follow-up abdominal CT performed 3 months later showed a 5.5-cm metastatic mass in the left subphrenic area. Laparoscopic splenectomy with mass excision was performed, and hepatoblastoma was confirmed histologically. A histologic re-examination of previously obtained surgical specimens also confirmed the presence of hepatoblastoma. Metastatic hepatoblastoma was found at multiple sites of the abdomen during follow-up, and so chemotherapy with cisplatin, 5-fluorouracil (5-FU), and vincristine was applied, followed by carboplatin and doxorubicin. Despite surgery and postoperative chemotherapy, she died 12 months after symptom onset. PMID:26523273

  8. Pituicytomas, a mis-diagnosed benign tumor of the neurohypophysis: report of three cases.

    PubMed

    Figarella-Branger, D; Dufour, H; Fernandez, C; Bouvier-Labit, C; Grisoli, F; Pellissier, J F

    2002-09-01

    Pituicytoma is a rare benign primary tumor of the neurohypophysis, occurring in the sellar and suprasellar spaces. We report here three new cases with immunohistochemical and electron microscopic study. Particular attention was paid to the expression of some cell adhesion molecules. These tumors were characterized by bundles of elongated cells strongly immunoreactive to anti-vimentin, S-100 protein, neural cell adhesion molecule and neuron-specific enolase antibodies. Glial fibrillary acidic protein (GFAP) was not recorded. It expressed the very late antigen alpha2 (VLAalpha2), but not VLAalpha5, and lacked epithelial markers expression (epithelial membrane antigen, E-cadherin), and specific neuronal markers (synaptophysin, chromogranin, neurofilament). Staining for pituitary hormones was negative. At the ultrastructural level, tumor/blood vessel basal lamina and cytoplasmic intermediate filaments were observed but desmosome or pericellular basal lamina were lacking. In one case few secretory granules were recorded. Differential diagnoses include granular cell tumors, pilocytic astrocytomas and spindle cell tumors such as solitary fibrous tumors, fibroblastic meningiomas and schwannomas. However, the unique pattern of antigenic expression and ultrastructural features of pituicytomas distinguish this rare tumor. As a subpopulation of pituicytes (which are distinctive glial cells of the neurophypophysis), some pituicytomas do not expressed GFAP. This suggests that pituicytomas presumably arise from pituicytes at various stages of their differentiation. PMID:12172918

  9. Group A Streptococci: A rare and often misdiagnosed cause of spontaneous bacterial peritonitis in adults

    PubMed Central

    Malota, Mark; Felbinger, Thomas W.; Ruppert, Reinhard; Nüssler, Natascha C.

    2014-01-01

    Introduction Acute primary peritonitis due to group A Streptococci (GAS) is a rare but life-threatening infection. Unlike other forms of primary peritonitis it affects predominantly young previously healthy individuals and thus is often confused with the more frequent secondary peritonitis. A case series of three patients is presented as well as a review of the literature focusing on pitfalls in the diagnose and therapy of GAS peritonitis. Methods A retrospective analysis of three patients with primary GAS peritonitis was performed. Furthermore a systematic review of all cases of primary GAS peritonitis published from 1990 to 2013 was performed comparing demographics and clinical presentation, as well as radiological imaging, treatment and outcome. Results All three female patients presented initially with high fever, nausea and severe abdominal pain. Radiological imaging revealed intraperitoneal fluid collections of various degrees, but no underlying cause of peritonitis. Broad antibiotic treatment was started and surgical exploration was performed for acute abdomen in all three cases. Intraoperatively fibrinous peritonitis was observed, but the correct diagnosis was not made until microbiological analysis confirmed GAS peritonitis. One patient died within 24 h after admission. The other two patients recovered after multiple surgeries and several weeks on the intensive care unit due to multiple organ dysfunction syndrome. The fulminant clinical course of the three patients resembled those of many of the published cases: flu-like symptoms, high fever, severe acute abdominal pain and fibrinous peritonitis without obvious infectious focus were the most common symptoms reported in the literature. Conclusion GAS primary peritonitis should be considered in particular in young, previously healthy women who present with peritonitis but lack radiological findings of an infectious focus. The treatment of choice is immediate antibiotic therapy. Surgical intervention is difficult to avoid, since the diagnosis of GAS peritonitis is usually not confirmed until other causes of secondary peritonitis have been excluded. PMID:25555146

  10. Oral squamous cell carcinoma misdiagnosed as a denture-related traumatic ulcer: A clinical report.

    PubMed

    Valente, Vitor Bonetti; Takamiya, Aline Satie; Ferreira, Lígia Lavezo; Felipini, Renata Callestini; Biasoli, Éder Ricardo; Miyahara, Glauco Issamu; Bernabé, Daniel Galera

    2016-03-01

    A 65-year-old woman presented with an ulcerated lesion in the alveolar ridge mucosa, which appeared after new dentures had been inserted. Despite many treatment attempts, the lesion did not recede, even with the interruption of denture wearing. A biopsy was performed, and histopathologic examination revealed an ulcerated, invasive, poorly differentiated oral squamous cell carcinoma. The time from the patient's first contact with the prosthodontist because of the lesion until the appropriate diagnosis was established was approximately 6 months. This clinical report documents a significant delay in the oral squamous cell carcinoma diagnosis and treatment because of a clinical misdiagnosis of a traumatic ulcer resulting from complete dentures. Prosthodontists should be aware of the importance of early diagnosis of oral cancer among elderly prosthesis wearers. PMID:26581660

  11. Hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS): a misdiagnosed disease entity

    PubMed Central

    Sundal, Christina; Lash, Jennifer; Aasly, Jan; ygarden, Sarka ; Roeber, Sigrun; Kretzschman, Hans; Garbern, James Y.; Tselis, Alex; Rademakers, Rosa; Dickson, Dennis W.; Broderick, Daniel; Wszolek, Zbigniew K.

    2011-01-01

    Hereditary diffuse leukoencephalopathy with spheroids (HDLS) was originally described in a large Swedish pedigree. Since then, 22 reports describing a total of 13 kindred's and 11 sporadic cases have been published. Inheritance is autosomal dominant, albeit the gene is unknown. Here we report on the clinical findings, genealogical data, brain MRI data, and autopsy/biopsy findings of four probands from three independently ascertained novel families from Norway, Germany and US. We identified a 39-year-old female and her twin sister, a 52-year-old male and a 47-year-old male with progressive neurological illness characterized by personality changes, cognitive decline and motor impairments, such as gait problems, bradykinesia, tremor and rigidity. Brain MRI showed white matter abnormalities with frontal prominence. Brain biopsy/autopsies were consistent with HDLS. HDLS is an under-recognized disease and in reporting these cases, we aim to increase the awareness of the disorder. Due to varied and wide phenotypic presentations, which may imitate several neurodegenerative diseases, HDLS can be difficult to diagnose. Definitive diagnosis can be established only by direct brain tissue examination. Familiarity with the clinical presentation and typical neuroimaging findings may be helpful in narrowing the diagnosis. PMID:22050953

  12. Coronary heart disease in sub-Saharan Africa: still rare, misdiagnosed or underdiagnosed?

    PubMed Central

    Luchuo, Engelbert B.

    2016-01-01

    Coronary heart disease (CHD) is the leading cause of death in developed countries, but it has generally been considered to be rare in sub-Saharan Africa (SSA). SSA is undergoing rapid epidemiological transition with an increasing prevalence of major cardiovascular risk factors and consequential cardiovascular diseases such as stroke. However, CHD including myocardial infarction has generally been considered to be rare despite this deterioration in the risk factors profile. There is an urgent need to raise awareness about CHD both in the general population and healthcare professionals while making available simple, inexpensive screening and diagnostic tools in sub-Saharan African countries. PMID:26885493

  13. Sodium Tetradecyl Sulphate Direct Intralesional Sclerotherapy of Venous Malformations of the Vulva and Vagina: Report of Five Cases

    SciTech Connect

    Krokidis, Miltiadis; Venetucci, Pietro; Hatzidakis, Adam; Iaccarino, Vittorio

    2011-02-15

    We report five cases of female patients affected by symptomatic focal external genital venous malformations treated with percutaneous direct intralesional injection of sodium tetradecyl sulphate (STS). All patients were referred because of discomfort and pain when sexual intercourse was attempted. Direct sclerotherapy with 3% STS was performed on a day-hospital basis with the patient under local anesthesia. Complete resolution of the symptoms was achieved in all cases. No major adverse effects were reported. Direct intralesional sclerotherapy with STS may be considered a safe and effective method for the treatment of female external genital malformation without the necessity of general anesthesia for pain control.

  14. Association of human papillomavirus type 16 with neoplastic lesions of the vulva and other genital sites by in situ hybridization.

    PubMed

    Gupta, J; Pilotti, S; Rilke, F; Shah, K

    1987-05-01

    The authors examined paraffin sections from 85 genital tract tissues from 49 cases for the presence of human papillomavirus (HPV) Types 6/11, 16, and 18 by stringent in situ hybridization using 35S-labeled viral DNA probes, and for viral capsid antigen by the immunoperoxidase test. The cases, selected mostly on the basis of vulvar pathology, were distributed as follows: early neoplasia (Group I, 6 cases); early neoplasia with viral cytopathic effect (CE) (Group II, 24 cases); and papillomavirus infection (PVI) (Group III, 19 cases). Available tissues from all affected sites were examined when the disease was multicentric. One or more viral DNAs were identified in 58% of 77 tissues from Groups II and III and in 2 of 8 tissues from Group I. HPV-6/11, HPV-16 and HPV-18 DNAs were detected, respectively, in 25, 24, and 2 tissues; 3 tissues were infected simultaneously with either two or three viruses. Viral DNA was identified at more than one site in 14 of 30 DNA-positive patients; in 10 of these, a single type was detected at all sites in the same patient. The viral DNA was localized mostly in areas showing viral cytopathology. The presence of HPV-16 correlated with neoplasia. HPV-16 DNA was identified in the 2 virus-positive tissues showing neoplasia, in 17 of 20 (85%) of the DNA-positive tissues showing neoplasia with CE, and in 5 of 25 (20%) of the DNA-positive tissues showing PVI. Conversely, HPV-6/11 was found in 25% of the DNA-positive tissues showing neoplasia with CE and in 80% of the cases of PVI. An HPV genome was identified in neoplastic cells in 14 instances; in all but 1 case, the genome was HPV-16. The association of HPV-16 with neoplasia was seen for both vulvar and cervical lesions. Viral antigen was detected in 83% of lesions associated with HPV 6/11 and in 62% of lesions associated with HPV-16. PMID:3034064

  15. Immunohistochemical staining for p16 and p53 in premalignant and malignant epithelial lesions of the vulva.

    PubMed

    Santos, Mónica; Montagut, Clara; Mellado, Begoña; García, Angel; Ramón y Cajal, Santiago; Cardesa, Antonio; Puig-Tintoré, Lluís M; Ordi, Jaume

    2004-07-01

    Two distinct types of vulvar squamous cell carcinomas and their precursors, vulvar intraepithelial neoplasias (VIN), which differ in terms of clinical presentation and behavior, have been delineated. Human papillomavirus (HPV)-associated carcinomas are of basaloid or warty type, whereas tumors unrelated to HPV are usually keratinizing and differentiated. Thus, the major stratifying factor for vulvar carcinomas and VIN is their etiopathogenetic relationship with HPV. However, because of technical difficulties in confidently detecting HPV in tissues, this diagnosis is usually based on purely morphologic criteria, even though some overlap exists between these histologic types. Recently, the tumor suppressor protein p16 has been shown to be specifically overexpressed in HPV-related carcinomas and premalignant lesions of the uterine cervix, oral cavity, and anus, but the presence of p16 vulvar squamous lesions has not been examined. We have evaluated the immunohistochemical expression of p16 in a series of formalin-fixed, paraffin-embedded vulvar carcinomas and their putative precursors. p16 was strongly positive in all cases of basaloid/condylomatous VIN3 (30/30) and basaloid (7/7) and warty (3/3) carcinomas. In contrast, p16 was almost consistently negative in normal skin, squamous cell hyperplasia (0/20), lichen sclerosus (0/19), differentiated (simplex) VIN3 (0/11), verrucous carcinoma (0/2), and keratinizing squamous cell carcinoma (3/33, 9%). One of the keratinizing squamous cell carcinomas positive for p16 occurred in a 25-year-old woman and the other two were associated with small foci of basaloid VIN3 adjacent to the tumor, suggesting a probable relationship with HPV. p16 was positive in 6 of 10 of basal cell carcinomas. In conclusion, p16 immunostaining is a good discriminator between HPV-associated and HPV-unrelated vulvar carcinomas and VIN, although it cannot differentiate basaloid squamous and basal cell carcinoma. PMID:15213596

  16. Unilateral Pigmented Extramammary Paget's Disease of the Axilla Associated with a Benign Mole: A Case Study and a Review of Literature.

    PubMed

    Ladak, Aleem; Bramley, Maria; Titi, Sami

    2014-08-01

    Pigmented extramammary Paget's disease (PEMPD) is an uncommon intraepithelial adenocarcinoma and a rare variant of Paget's disease affecting skin that is rich in apocrine sweat glands such as the axilla, perianal region and vulva. It most commonly occurs in postmenopausal women and presents as a superficial pigmented scaly macule, mimicking a melanocytic lesion. The histological presentation is adenocarcinoma in situ with an increased number of melanocytes scattered between the Paget's cells. Therefore, PEMPD may be misdiagnosed as a melanocytic tumour both clinically and histologically. The tumour cells are usually positive for cytokeratin 7, epithelial membrane antigen, Cam 5.2, HER2, and mucicarmine stain while S100 and human melanoma black-45 highlight the processes of reactive dendritic cells. The association between Paget's cells and intratumoural reactive melanocytes is still unclear. We report our first case of PEMPD associated with an intradermal naevus involving the axilla in a 63-year-old woman. PMID:25214861

  17. Vulvar metastasis from carcinoma breast unveiling distant metastasis: Exploring an unusual metastatic pattern.

    PubMed

    Gandhi, Ajeet Kumar; Roy, Soumyajit; Mridha, Asit Ranjan; Sharma, Daya Nand

    2015-12-01

    A 76 year old woman with a previous history of infiltrating ductal carcinoma of right breast (diagnosed and treated 14 years back) presented to us with a non-healing ulcer on the left side of the vulva along with two satellite nodules close to the vulvar lesion. Biopsy showed an infiltrating ductal carcinoma of breast with a strong positivity for estrogen/progesterone receptors. Further, (18)F-FDG PET-CT (Fluoro-deoxy glucose positron emission tomography computed tomography) showed multiple bilateral lung metastases. She responded well to hormone therapy (Letrozole) with decrease in the size of primary vulvar lesion and disappearance of the satellite nodules. Repeating PET-CT at 6 months showed partial response of the lung lesions. The present case is unique in the way of metastatic presentation of breast cancer to vulva after a long gap of primary diagnosis (longest reported till date) and also in unveiling of further metastatic sites in otherwise asymptomatic case. Patients (particularly elderly) with this unusual and clinically isolated pattern of metastasis might remain misdiagnosed for a long period of time and this case report aims to increase the awareness of clinicians toward the same. Gynecological surveillance remains of paramount importance in the follow up of breast cancer. PMID:26160598

  18. Neonatal small intestinal zygomyocosis misdiagnosed as intussusception in a two-day-old child with a review of the literature.

    PubMed

    Agrawal, Pallavi; Saikia, Uma; Ramanaathan, Subbaih; Samujh, Ram

    2013-12-01

    Neonatal mucormycosis is caused by fungi belonging to the class Zygomycetes. Clinically, it mimics necrotizing enterocolitis. We describe a case of 2-day-old baby who presented with abdominal distension and vomiting. A clinical diagnosis of intussusception was suspected. An exploratory laprotomy revealed gangrenous bowel wall and no intussusception or any gas-filled vesicles. Histological examination of the gangrenous segment showed transmural ischemic necrosis with fungal hyphae of zygomycosis. The baby is doing well postoperatively at a follow-up of 3 months. Hence, a high degree of clinical suspicion is important in neonates not responding to usual therapy or antibiotics. PMID:24044628

  19. Unbalanced interchromosomal insertion diagnosed prenatally by FISH, with carrier mother, previously misdiagnosed as having a balanced reciprocal translocation

    SciTech Connect

    Yu, M.T.; Leiber, E.; Qazi, Q.

    1994-09-01

    Insertion translocations are rare. A carrier with a balanced insertion translocation is most likely to be detected through offspring with an unbalanced translocation. We with to report a case where a correct diagnosis, made prenatally with FISH, corrected the initial misdiagnosis of the mother in another institute. PDL received an amniotic fluid sample from a 28 y.o. woman (G5P2Sab1TOP1) at 19 wks gestation. The indications were a reported balanced translocation, t(6;13), in the mother and a previous daughter with an unbalanced translocation. Chromosome analysis of the amniocytes showed a female karyotype with an abnormal chr. 13. Since the mother was diagnosed as having t(6;13)(q21;q34), the der(13) in the amniocytes was initially assumed to result from an adjacent segregation of the t(6;13). However, the banding patterns of this abnormal chr. 13 did not fit into the above defined translocation. With FISH and a chr. 13 painting probe, this der(13) was painted in the proximal and the distal thirds, but NOT in the middle region. This indicates that the middle section of the der(13) must have originated from 6q. The banding pattern is compatible with a direct insertion of 6q15 to 6q23.3 into 13q21.2. Thus, the fetus has partial trisomy 6q. After counseling, the mother elected to terminate the pregnancy but later changed her mind. An 8 lb 12 oz baby girl was born at 36 wks. (mother diabetic). Chromosome analysis of the newborn blood confirmed the dx. The mother was studied, using multicolor painting probes for chromosomes 13 and 6, a balanced direct insertion of 6q15 to 6q23.3 into chr. 13q21.2 was clearly shown. The previous affected daughter with a 13q+ is now 4 y.o. (a restudy is planned). She has microcephaly, severe developmental delay and other dysmorphic features. This case illustrates the advantage of using FISH to arrive at a definitive diagnosis of an insertion translocation.

  20. Vanished Twins and Misdiagnosed Sex: A Case Report with Implications in Prenatal Counseling Using Noninvasive Cell-Free DNA Screening.

    PubMed

    Kelley, James F; Henning, George; Ambrose, Anthony; Adelman, Alan

    2016-01-01

    Cell-free DNA testing is a recently introduced method for screening pregnant women for fetal trisomy, which is associated with some common significant genetic diseases, as well as the sex of the fetus. The case described here demonstrates the connection between the ultrasound "vanishing twin" phenomenon and the misdiagnosis of prenatal sex using cell-free DNA testing. PMID:27170800

  1. A case of multiple evanescent white dot syndrome misdiagnosed as optic neuritis: Differential diagnosis for the neurologist

    PubMed Central

    Pellegrini, Francesco; Interlandi, Emanuela

    2016-01-01

    A 25-year-old female presented to a local hospital for acute onset of a central scotoma in the left visual field. She was visited by the neurologist, and a diagnosis of left retrobulbar optic neuritis was made. Magnetic resonance imaging scan was normal. Ophthalmic examination revealed a multiple evanescent white dot syndrome. After a description of the case, a brief differential diagnosis between these two entities is made. The neurologist should be aware of this uncommon condition.

  2. Vitamin B12 Deficiency and Hemoglobin H Disease Early Misdiagnosed as Thrombotic Thrombocytopenic Purpura: A Series of Unfortunate Events

    PubMed Central

    Andreadis, Panagiotis; Theodoridou, Stamatia; Pasakiotou, Marily; Arapoglou, Stergios; Gigi, Eleni; Vetsiou, Evaggelia; Vlachaki, Efthymia

    2015-01-01

    We herein would like to report an interesting case of a patient who presented with anemia and thrombocytopenia combined with high serum Lactic Dehydrogenase where Thrombotic Thrombocytopenic Purpura was originally considered. As indicated a central venous catheter was inserted in his subclavian vein which led to mediastinal hematoma and finally intubation and Intensive Care Unit (ICU) hospitalization. After further examination patient was finally diagnosed with B12 deficiency in a setting of H hemoglobinopathy. There have been previous reports where pernicious anemia was originally diagnosed and treated as Thrombotic Thrombocytopenic Purpura but there has been none to our knowledge that was implicated with hemothorax and ICU hospitalization or correlated with thalassemia and we discuss the significance of accurate diagnosis in order to avoid adverse reactions and therapy implications. PMID:26609455

  3. Notes from the Field: Group A Streptococcal Pharyngitis Misdiagnoses at a Rural Urgent-Care Clinic - Wyoming, March 2015.

    PubMed

    Harrist, Alexia; Van Houten, Clayton; Shulman, Stanford T; Van Beneden, Chris; Murphy, Tracy

    2016-01-01

    Group A Streptococcus (GAS) is the most common bacterial cause of pharyngitis, implicated in 20%-30% of pediatric and 5%-15% of adult health care visits for sore throat (1). Along with the sudden onset of throat pain, GAS pharyngitis symptoms include fever, headache, and bilateral tender cervical lymphadenopathy (1,2). Accurate diagnosis and management of GAS pharyngitis is critical for limiting antibiotic overuse and preventing rheumatic fever (2), but distinguishing between GAS and viral pharyngitis clinically is challenging (1). Guidelines for diagnosis and management of GAS pharyngitis have been published by the Infectious Diseases Society of America (IDSA)* (1). IDSA recommends that patients with sore throat be tested for GAS to distinguish between GAS and viral pharyngitis; however, IDSA emphasizes the use of selective testing based on clinical symptoms and signs to avoid identifying GAS carriers rather than acute GAS infections (1). Therefore, testing for GAS usually is not recommended for the following: patients with sore throat and accompanying symptoms (e.g., cough, rhinorrhea) that strongly suggest a viral etiology; children aged <3 years, because acute rheumatic fever is extremely rare in this age group; and asymptomatic household contacts of patients with GAS pharyngitis (1). IDSA recommends penicillin or amoxicillin as the treatment of choice based on effectiveness and narrow spectrum of activity. To date, penicillin-resistant GAS has never been documented (1). PMID:26719990

  4. Phosphatidylglycerol determination in the amniotic fluid from a PAD placed over the vulva: a method for diagnosis of fetal lung maturity in cases of premature ruptured membranes.

    PubMed

    Estol, P C; Poseiro, J J; Schwarcz, R

    1992-01-01

    Four hundred and forty seven pregnant women with ruptured membranes, were prospectively studied in order to assess the diagnostic capacity of Phosphatidylglycerol (PhG) determination in amniotic fluid recovered from vulval pads in the diagnosis of Hyaline Membrane Disease (HMD). The identification of PhG was performed using one dimensional silica gel thin layer chromatography. The sensitivity of PhG determination in the diagnosis of HMD in newborns of the total population was found to be 88.2%, with a specificity of 76.9%. In the study population, the incidence of HMD was 7.6%, the negative predictive value was 98.8% and, the positive predictive value was 24.0%. When the 265 newborns of the gestational age group of less than or equal to 34 weeks is considered, we observed an incidence of HMD of 12.1%. The diagnostic capacity of PhG in this group was shown by a sensitivity of 87.5%, a specificity of 76.4%, a positive predictive value of 33.7% and a negative predictive value of 97.8%. This method of assessment of fetal lung maturity has a diagnostic capability similar to that described by other authors, who used amniotic fluid obtained vaginally or transabdominally. The procedure described here of amniotic fluid collection is non-invasive, harmless to the mother and fetus and simple to perform. The characteristics of this method, allow serial studies of the amniotic fluid to be carried out. PMID:1608026

  5. A case of sudden death after ultrasound-guided percutaneous alcohol injection of a paraganglioma mis-diagnosed as a peri-renal cyst.

    PubMed

    Andrello, L; Visonà, S D; Osculati, A

    2015-08-01

    Paragangliomas are cromaffin tumors arising from the neural crest cells of parasympathetic or sympathetic ganglia. They are known to be rare causes of sudden death. Here we present the autopsy findings, as well as microscopical and immunohistochemistry study, of a 48-years-old woman who died suddenly after a percutaneous alcohol injection of a peri-renal cyst previously diagnosed as a common complex cyst. She manifested a multiorgan failure, with acute heart failure, systemic and pulmonary vasoconstriction with hypoxia, metabolic acidosis (pH 6.974). It was therefore enacted resuscitation that was ineffective. The autopsy pointed out, close to the upper right renal pole, a cyst characterized by very friable walls and septa, with a thickness of approximately 0.5cm and containing about 75cm(3) of hemoserous fluid. Microscopically, through immunohistochemical examinations, the cyst showed the presence of chromaffin cells, containing enzymes involved in the synthesis of catecholamines, in particular noradrenalin. So, the cause of the death was ascertained in an multi-organ failure caused by a massive release of catecholamines (noradrenaline) from the cyst, identified post-mortem (on the basis of histologic and immunohistochemical examinations) in a noradrenalin-secreting paraganglioma, that remained silent until the cyst ablation. PMID:26055308

  6. Spontaneous gallbladder perforation in a patient of situs inversus totalis, misdiagnosed as perforation peritonitis due to gas under the right dome of the diaphragm.

    PubMed

    Kumar, Sanjeev; Kumar, Shailendra; Kumar, Suresh; Gautam, Shefali

    2015-01-01

    Acute biliary tract disease is a common condition in adults. Apart from bile duct perforation, spontaneous perforation of the gallbladder itself is very rare in all age groups; to date, all recorded cases are secondary to coexistent disease. We present the case report of a 60-year-old adult having an idiopathic gallbladder perforation. In our case, an unusual presentation was situs inversus totalis and fundal gas shadow was considered as free air under the right dome of the diaphragm by mistake. The patient underwent laparotomy and emergency cholecystectomy was performed in the perforated gallbladder. To date, no case has been described in the literature. PMID:26123454

  7. Non-lesions, Misdiagnoses, Missed Diagnoses, and Other Interpretive Challenges in Fish Histopathology Studies: A Guide for Investigators, Authors, Reviewers, and Readers

    EPA Science Inventory

    Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negativ...

  8. The Case of a Zebra That Was Misdiagnosed as a Horse: Pulmonary Tumor Thrombotic Microangiopathy, a New Paraneoplastic Syndrome, Mimicking PD-1-Induced Pneumonitis

    PubMed Central

    Carter, Corey A.; Browning, Robert; Oronsky, Bryan T.; Scicinski, Jan J.; Brzezniak, Christina

    2016-01-01

    A case report of a 47-year-old woman with triple-negative breast cancer on a clinical trial called PRIMETIME (NCT02518958) who received the anti-PD-1 inhibitor nivolumab and the experimental anticancer agent RRx-001 is presented. Although initially diagnosed and treated for anti-PD-1-induced pneumonitis, clinical and radiological abnormalities triggered further investigation, leading to the diagnosis of pulmonary tumor thrombotic microangiopathy (PTTM). This example highlights the importance of exercising due diligence in determining immune-related adverse events and suggests that PD-1-induced pneumonitis should be a diagnosis of exclusion rather than a diagnosis by default. A case history and review of the literature are presented for PTTM, which we propose to define as a paraneoplastic syndrome. PMID:26933422

  9. PID in Disguise: Molecular Diagnosis of IRAK-4 Deficiency in an Adult Previously Misdiagnosed With Autosomal Dominant Hyper IgE Syndrome.

    PubMed

    Frans, Glynis; Moens, Leen; Schrijvers, Rik; Wuyts, Greet; Bouckaert, Bernard; Schaballie, Heidi; Dupont, Lieven; Bossuyt, Xavier; Corveleyn, Anniek; Meyts, Isabelle

    2015-11-01

    Autosomal recessive IL-1R-associated kinase 4 (IRAK-4) deficiency is a rare cause of recurrent pyogenic infections with limited inflammatory responses. We describe an adult female patient with severe lung disease who was phenotypically diagnosed as suffering from autosomal dominant Hyper IgE syndrome (AD HIES) because of recurrent skin infections with Staphylococcus aureus, recurrent pneumonia and elevated serum IgE levels. In contrast to findings in AD HIES patients, no abnormalities were found in the Th17 and circulating follicular helper T cell subsets. A panel-based sequencing approach led to the identification of a homozygous IRAK4 stop mutation (c.877C > T, p.Gln293*). PMID:26472314

  10. Lung Infarction due to Pulmonary Vein Stenosis after Ablation Therapy for Atrial Fibrillation Misdiagnosed as Organizing Pneumonia: Sequential Changes on CT in Two Cases

    PubMed Central

    Kwon, Mi-ri; Cho, Jong Ho; Um, Sang-Won

    2015-01-01

    Pulmonary vein (PV) stenosis is a complication of ablation therapy for arrhythmias. We report two cases with chronic lung parenchymal abnormalities showing no improvement and waxing and waning features, which were initially diagnosed as nonspecific pneumonias, and finally confirmed as PV stenosis. When a patient presents for nonspecific respiratory symptoms without evidence of infection after ablation therapy and image findings show chronic and repetitive parenchymal abnormalities confined in localized portion, the possibility of PV stenosis should be considered. PMID:26175597

  11. Primary parapharyngeal and skull base synovial sarcoma in a 13-year-old boy with neurofibromatosis radiologically misdiagnosed as a benign lesion

    PubMed Central

    Taghipour Zahir, Shokouh; Sharahjin, Naser Sefidrokh; Dadgarnia, Mohammad Hossein

    2013-01-01

    Synovial sarcoma is a rare form of malignant tumour and accounting approximately for 8% of all soft tissue sarcomas. Head and neck synovial sarcomas are uncommon and parapharyngeal space involvement is extremely rare. We report a case of synovial sarcoma in the parapharyngeal space of a 13-year-old boy with a history of neurofibromatosis presented with odynophagia, ptosis and left submandibular mass. The lesion extended from retrostyloid parapharyngeal space to the skull base and foramen jugular superiorly. The first clinical and radiological impressions were carotid jugular related tumours such as schwannoma and paraganglioma. PMID:23737583

  12. Behavioral and Movement Disorders due to Long-Lasting Myoclonic Status Epilepticus Misdiagnosed as ADHD in a Patient With Juvenile Myoclonic Epilepsy: Electroclinical Findings and Related Hemodynamic Changes.

    PubMed

    Fanella, Martina; Carnì, Marco; Morano, Alessandra; Albini, Mariarita; Lapenta, Leonardo; Casciato, Sara; Fattouch, Jinane; Di Castro, Elisabetta; Colonnese, Claudio; Vaudano, Anna Elisabetta; Giallonardo, Anna Teresa; Di Bonaventura, Carlo

    2016-01-01

    Epilepsy and attention-deficit/hyperactivity disorder (ADHD) likely share common underlying neural mechanisms, as often suggested by both the evidence of electroencephalography (EEG) abnormalities in ADHD patients without epilepsy and the coexistence of these 2 conditions. The differential diagnosis between epilepsy and ADHD may consequently be challenging. In this report, we describe a patient presenting with a clinical association of "tics" and behavioral disorders that appeared 6 months before our first observation and had previously been interpreted as ADHD. A video-EEG evaluation documented an electroclinical pattern of myoclonic status epilepticus. On the basis of the revised clinical data, the EEG findings, the good response to valproate, the long-lasting myoclonic status epilepticus, and the enduring epileptic abnormalities likely causing behavioral disturbances, the patient's symptoms were interpreted as being the expression of untreated juvenile myoclonic epilepsy. The EEG-functional magnetic resonance imaging study revealed, during clinical generalized spike-and-wave and polyspike-and-wave discharges, positive blood oxygen level-dependent (BOLD) signal changes bilaterally in the thalamus, the prefrontal cortex (Brodmann area 6, supplementary motor area) and the cerebellum, and negative BOLD signal changes in the regions of the default mode network. Such findings, which are typical of BOLD changes observed in idiopathic generalized epilepsy, may also shed light on the anatomofunctional network underlying ADHD. PMID:25733678

  13. “Why do I always see double?” A misdiagnosed case of ocular myasthenia gravis for 10 years

    PubMed Central

    Mohamed Yousuf, Uduman Ali; Yashodhara, B M; Thanigasalam, Thevi; Ting, Heng Siang

    2014-01-01

    A 58-year-old man presented with diplopia and partial ptosis for 10 years. It was non-progressive in nature, despite inadequate medical attention the patient received from non-specialists/general practitioners. He did not have fatigability or diurnal variation in weakness and was clinically stable without exacerbations of disease for a decade. He did not have features of Graves's disease, oculopharyngeal dystrophy, cranial nerve paralysis, polymyositis and stroke. The possibility of an atypical presentation of myasthenia gravis (MG) was considered and the patient was evaluated. Ice pack test was negative, Cogan's lid twitch (CLT) test was positive and high titres of acetylcholine receptor antibodies (AChR Ab) suggestive of MG were found. He was treated accordingly with a very good response. PMID:24792021

  14. Children with Disabilities Are Often Misdiagnosed Initially and Children with Neuropsychiatric Disorders Are Referred to Adequate Resources 30 Months Later than Children with Other Disabilities

    ERIC Educational Resources Information Center

    Tuominen-Eriksson, Alli-Marie; Svensson, Yvonne; Gunnarsson, Ronny K.

    2013-01-01

    Disabilities in a child may lead to low self-esteem and social problems. The lives of parents and siblings are also affected. Early intervention may decrease these consequences. To promote early intervention early referral to adequate resources is essential. In a longitudinal retrospective observational study it was found that children with…

  15. Genital pyoderma gangrenosum: report of two cases and published work review of Japanese cases.

    PubMed

    Satoh, Masataka; Yamamoto, Toshiyuki

    2013-10-01

    Pyoderma gangrenosum is an ulcerative skin disorder showing characteristic non-infectious ulcers and affects the lower extremities in approximately 70% of cases. Pyoderma gangrenosum is commonly associated with systemic diseases such as inflammatory bowel disease, rheumatoid arthritis and hematological malignancies. Herein, we report two cases of Japanese patients diagnosed with genital pyoderma gangrenosum. Case 1 was a 74-year-old woman without associated systemic complications, whose skin lesion resembled a squamous cell carcinoma and was limited to the vulva. Case 2 is an 89-year-old man, who suffered from myelodysplastic syndrome and acute myeloid leukemia, and presented with penile and leg ulcers mimicking pressure sores. Both cases responded well to systemic steroids. We review 13 genital pyoderma gangrenosum cases (76.9% male; aged 30-89 years) from 1996 to 2012 in Japan, including 11 previously reported cases and the present study's two cases. Four of the 13 genital pyoderma gangrenosum cases had associated systemic diseases and their skin lesions spread to the extragenital areas. Eight of the remaining nine genitalia-localized pyoderma gangrenosum cases had no associated systemic diseases. In conclusion, genital pyoderma gangrenosum is rare and may be misdiagnosed. It should therefore be considered in cases of refractory genital ulcers. In addition, genitalia-localized pyoderma gangrenosum tends to be without systemic complications. PMID:24033392

  16. Cervical Myomas

    MedlinePlus

    ... and Epidermal Cysts of the Vulva Skene Duct Cyst Noncancerous Ovarian Growths Polyps of the Cervix Cervical myomas are ... and Epidermal Cysts of the Vulva Skene Duct Cyst Noncancerous Ovarian Growths Polyps of the Cervix NOTE: This is ...

  17. Cervical Stenosis

    MedlinePlus

    ... and Epidermal Cysts of the Vulva Skene Duct Cyst Noncancerous Ovarian Growths Polyps of the Cervix Cervical stenosis is ... and Epidermal Cysts of the Vulva Skene Duct Cyst Noncancerous Ovarian Growths Polyps of the Cervix NOTE: This is ...

  18. Intradermal spitz nevi: a rare subtype of spitz nevi analyzed in a clinicopathologic study of 74 cases.

    PubMed

    Plaza, Jose A; De Stefano, Danielle; Suster, Saul; Prieto, Victor G; Kacerovska, Denisa; Michal, Michal; Sangueza, Martin; Kazakov, Dmitry V

    2014-04-01

    Spitz nevi are acquired melanocytic lesions with a wide histomorphological spectrum; reliable distinction from spitzoid melanoma is often difficult. Misdiagnoses of benign spitzoid tumors as spitzoid melanomas and vice versa are attributable to a frequently disturbing morphology and inconsistent or poorly defined histological criteria for diagnosis. Many recognized histological variants of Spitz nevi have been described, including the intradermal Spitz. Histopathologic descriptions of intradermal Spitz nevi have been done in the past; however, large studies addressing their histological spectrum have been lacking. We have retrospectively assessed the morphological features in 74 cases of intradermal Spitz nevi, excluding tumors clearly defined as atypical Spitz nevi and Spitzoid melanomas, to further delineate their histological spectrum. The patients' ages ranged from 5 to 81 years (median: 27). Anatomic location included: the upper extremities (27 cases), followed by head and neck (22 cases), lower extremities (9 cases), back (8 cases), buttock (5 cases), chest (1 case), and vulva (1 case). In 1 case, the anatomic location of the lesion was not available. Different histological variants were observed including hyalinized, polypoid, desmoplastic, angiomatoid, and halo Spitz. Morphological features evaluated included symmetry (100%), cell type (epithelioid 42%, spindle 16%, mixed 42%), maturation (85%), pigmentation (26%), chronic inflammation (24%), and mitotic activity (38%). Mild atypia was seen in 36 cases (49%), moderate atypia was seen in 28 cases (38%), and severe atypia was seen in 10 cases (14%). Intradermal Spitz nevus is a distinctive type of Spitz nevus that sometimes can be difficult to define given the unusual features that these lesions can show; thus, strict application of well-defined histological criteria and awareness of their morphological spectrum will facilitate definitive diagnosis. PMID:24736667

  19. Immunoproteomic Analysis of the Excretory-Secretory Proteins from Spirometra mansoni Sparganum

    PubMed Central

    HU, Dan Dan; CUI, Jing; WANG, Li; LIU, Li Na; WEI, Tong; WANG, Zhong Quan

    2013-01-01

    Background Sparganosis is caused by the invasion of Spirometra sparganum into various tissues/organs. Subcutaneous sparganosis can be diagnosed by biopsy, while visceral/cerebral sparganosis is not easy to be diagnosed. The diagnosis depends largely on the detection of specific anti-sparganum antibodies. The specificity of the ELISA could be increased by using S. mansoni sparganum excretory–secretory (ES) antigens, but it also had the cross-reactions with sera of patients with cysticercosis or paragonimiasis. The aim of this study was to identify early specific diagnostic antigens in S. mansoni sparganum ES proteins. Methods The sparganum ES proteins were analyzed by two-dimensional electrophoresis (2-DE) and Western blot probed with early sera from infected mice at 14 days post-infection. The immunoreactive protein spots were characterized by MALDI-TOF/ TOF-MS. Results A total of approximately 149 proteins spots were detected with isoelectric point (pI) varying from 3 to 7.5 and molecular weight from 20 to 115 kDa and seven protein spots with molecular weight of 23-31 kDa were recognized by the infection sera. Three of seven spots were successfully identified and characterized as the same S. mansoni protein (cysteine protease), and the proteins of other 4 spots were not included in the databases. Conclusion The cysteine protease from S. mansoni ES proteins recognized by early infection sera might be the early diagnostic antigens for sparganosis. PMID:24454434

  20. A waterborn zoonotic helminthiase in an Italian diver: a case report of a cutaneous Sparganum infection and a review of European cases.

    PubMed

    Bracaglia, Giorgia; Ranno, Stefania; Mancinelli, Livia; Santoro, Maristella; Cerroni, Lorenzo; Massone, Cesare; Sangueza, Omar; Bravo, Francisco G; Diociaiuti, Andrea; Nicastri, Emanuele; Muraca, Maurizio; El Hachem, May; Boldrini, Renata; Callea, Francesco; Putignani, Lorenza

    2015-12-01

    Many waterborne helminthes are opportunistic parasites that can travel directly from animals to man and may contain forms capable of penetrating the skin. Among these, Sparganum is the pseudophyllidean tapeworm that belongs to the genus Spirometra, which is responsible for parasitic zoonosis; it is rarely detected in Europe and is caused by the plerocercoid infective larva. Thus far, only six cases of cutaneous and ocular sparganosis have been reported in Europe; two and four cases have occurred in France and Italy, respectively. Herein, we describe a new case of sparganosis in Italy that affected a male diver who presented to the Bambino Gesù Children's Hospital of Rome. The patient's skin biopsy was submitted to the Parasitology department who, in consultation with Pathology, concluded that the morphologic and microscopic findings were those of Sparganum spp. larvae. The patient recovered following a single dose of 600 mg praziquantel. PMID:26751512

  1. An Unusual Cause of a Breast Mass in a Patient from China.

    PubMed

    Nathavitharana, Ruvandhi R; Fleischmann-Rose, Kristin; Yassa, David S; Wertheimer, Michael D; Alonso, Carolyn D

    2015-08-01

    Sparganosis is a parasitic infection caused by Spirometra spp. and often presents as a subcutaneous swelling, most commonly noticed in the abdominal wall or extremities. Amphibians such as frogs ingest infected copepods (crustaceans that have ingested coracidia, i.e., Spirometra spp. embryos) and serve as a secondary intermediate host. Complete surgical excision is recommended for definitive diagnosis and treatment. Granulomatous inflammation is the most common histologic finding. Although dissemination can occur, most cases are localized. Serum enzyme-linked immunosorbent assay (ELISA) has been suggested as a potential surveillance tool. Medical therapy with antiparasitic agents, such as praziquantel, is not typically recommended but may be effective at high doses. Preventing recurrence thus depends on adequate surgical removal of the parasite. We report a case of a breast mass caused by sparganosis infection in a Chinese female whose likely exposure was due to frog consumption. The diagnosis was confirmed on surgical excision and no systemic antiparasitic therapy was required. PMID:26033021

  2. Bleomycin

    MedlinePlus

    ... with other medications to treat head and neck cancer (including cancer of the mouth, lip, cheek, tongue, palate, throat, tonsils, and sinuses) and cancer of the penis, testicles, cervix, and vulva (the ...

  3. What Is Vulvar Cancer?

    MedlinePlus

    ... cancers start and spread, see What Is Cancer? Squamous cell carcinomas Most cancers of the vulva are squamous cell ... of skin cells. There are several subtypes of squamous cell carcinoma: The keratinizing type is most common, and usually ...

  4. Adnexal Torsion

    MedlinePlus

    ... an overnight stay in the hospital. If an ovarian cyst is present and the ovary can be saved, ... and Epidermal Cysts of the Vulva Skene Duct Cyst Noncancerous Ovarian Growths Polyps of the Cervix NOTE: This is ...

  5. Your First Gynecologic Visit

    MedlinePlus

    ... Vagina: A tube-like structure surrounded by muscles leading from the uterus to the outside of the body. Vulva: The external female genital area. If you have further questions, contact your obstetrician–gynecologist. FAQ150: Designed as an ...

  6. Endocervical gram stain

    MedlinePlus

    ... Elsevier Saunders; 2011:chap 293. Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, ... toxic shock syndrome, endometritis, and salpingitis. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive ...

  7. Vaginitis - self-care

    MedlinePlus

    ... Saunders Elsevier; 2011:chap 543. Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, ... toxic shock syndrome,endometritis, and salpingitis. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive ...

  8. Bartholin cyst or abscess

    MedlinePlus

    ... Saunders Elsevier; 2013:chap 37. Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, ... toxic shock syndrome, endometritis, and salpingitis. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive ...

  9. Genital sores - female

    MedlinePlus

    ... DC. Neoplastic diseases of the vulva. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds . Comprehensive ... Mosby Elsevier; 2012:chap 30. Eckert L, Lentz GM. Infections of the lower genital tract. In: Lentz ...

  10. Clinical, genetic, and pathological features of male pseudohermaphroditism in dog

    PubMed Central

    2011-01-01

    Male pseudohermaphroditism is a sex differentiation disorder in which the gonads are testes and the genital ducts are incompletely masculinized. An 8 years old dog with normal male karyotype was referred for examination of external genitalia abnormalities. Adjacent to the vulva subcutaneous undescended testes were observed. The histology of the gonads revealed a Leydig and Sertoli cell neoplasia. The contemporaneous presence of testicular tissue, vulva, male karyotype were compatible with a male pseudohermaphrodite (MPH) condition. PMID:21255434

  11. A successful pregnancy outcome in treated vulval rhabdomyosarcoma.

    PubMed

    Ariza, M; Rafaee, T; Adeeb, N; Muhaizan, W M; Isa, M R

    1999-09-01

    A 14 year old girl presented in 1986 with a huge perineal swelling which was progressively increasing in size and associated with loss of weight and loss of appetite. Biopsy from the mass revealed rhabdomyosarcoma of the vulva. She was treated with chemotherapy and radium implant. She responded well to the regime. Fibrosis of the vulva and vagina caused difficulty in consummation. Once it was corrected, she conceived easily and proceeded to a normal pregnancy and delivery. PMID:11045067

  12. Language disorder - children

    MedlinePlus

    ... These conditions are sometimes misdiagnosed as developmental disorders. Language disorders may occur in children with other developmental problems, autistic spectrum disorder, hearing loss, and learning disabilities. A ...

  13. Pseudorheumatoid dysplasia. A rare genetic disorder simulating juvenile idiopathic arthritis.

    PubMed

    Duarte-Salazar, Carolina; Santillán-Chapa, Concepción Guadalupe; Martínez-Coria, Elisa; Marin-Arriaga, Norma; Miranda-Duarte, Antonio

    2013-01-01

    We present the case of a teenage patient with progressive pseudorheumatoid dysplasia, an autosomal recessive disorder that may be initially misdiagnosed as juvenile idiopathic arthritis. PMID:23265789

  14. Neuroparasitic Infections: Cestodes, Trematodes, and Protozoans

    PubMed Central

    Walker, M.D.; Zunt, J.R.

    2009-01-01

    Parasitic infection of the nervous system can produce a variety of symptoms and signs. Because symptoms of infection are often mild or nonspecific, diagnosis can be difficult. Familiarity with basic epidemiological characteristics and distinguishing radiographic findings can increase the likelihood of detection and proper treatment of parasitic infection of the nervous system. This article discusses the clinical presentation, diagnosis, and treatment for some of the more common infections of the nervous system caused by cestodes, trematodes and protozoans: Echinococcus spp., Spirometra spp. (sparganosis), Paragonimus spp., Schistosoma spp., Trypanosoma spp., Naegleria fowlerii, Acanthamoeba histolytica, and Balamuthia mandrillaris. PMID:16170739

  15. Pulmonary cryptococcosis presenting as acute severe respiratory distress in a newly diagnosed HIV patient in Tanzania: a case report

    PubMed Central

    Gunda, Daniel W; Bakshi, Fatma A; Rambau, Peter; Kilonzo, Semvua B

    2015-01-01

    Key Clinical Message Pulmonary cryptococcosis is a common condition in HIV-infected patients which is frequently missed or misdiagnosed in resource-limited countries. We report a case of HIV/AIDS patient who was misdiagnosed with a fatal outcome. There is a need to implement screening tools to be used where the diagnosis may not be confirmed. PMID:26401280

  16. Isolated Left Ventricular Noncompaction Cardiomyopathy diagnosed by Transesophageal Echocardiography

    PubMed Central

    Bhat, Tariq; Lafferty, James; Teli, Sumaya; Rjaili, Georges Abou; Olkovsky, Yefim; Costantino, Thomas

    2011-01-01

    Isolated noncompaction of the ventricular myocardium has often been misdiagnosed as other cardiomyopathies because it is a relatively recently described cardiomyopathy with literature limited to case reports and case series and little awareness among physicians. We are reporting a case of isolated left ventricular noncompaction cardiomyopathy that was misdiagnosed for over two decades. PMID:21487457

  17. Comparison of molecular abnormalities in vulvar and vaginal melanomas.

    PubMed

    Aulmann, Sebastian; Sinn, Hans P; Penzel, Roland; Gilks, C Blake; Schott, Sarah; Hassel, Jessica C; Schmidt, Dietmar; Kommoss, Friedrich; Schirmacher, Peter; Kommoss, Stefan

    2014-10-01

    Malignant melanoma of the vulva and vagina is relatively uncommon and accounts for <5% of all melanomas in women. The aim of our study was to establish the biological properties and evaluate potential therapeutic targets in these tumors. We collected a series of 65 cases from three centers and re-evaluated the tumor tissue for predominant growth pattern (superficial spreading, nodular, and mucosal lentiginous) and tumor thickness. KIT (CD117) expression was detected immunohistochemically. In addition, tumors were screened for BRAF, NRAS, and KIT mutations by PCR and DNA sequencing as well as for KIT amplifications by fluorescence in situ hybridization. None of the cases contained BRAF mutations. NRAS mutations and KIT amplifications were detected in similar frequency (?12%) in tumors of the vulva and vagina. In contrast, KIT mutations were present in 18% of primary melanomas of the vulva, but in none of the tumors arising in the vagina. Moderate or strong KIT protein expression was detected in 30 cases, including all tumors with KIT mutations and 6 of the 7 with KIT amplifications. In conclusion, BRAF mutations are virtually absent in melanomas originating from the vulva or vagina, whereas NRAS mutations and KIT amplifications occur in both locations. KIT mutations appear to be specific for melanomas of the vulva, suggesting that in spite of the anatomic proximity, the development of vulvar and vaginal melanomas involves different molecular alterations which may be targeted by novel treatment approaches. PMID:24603591

  18. Spirometra (Pseudophyllidea, Diphyllobothriidae) Severely Infecting Wild-Caught Snakes from Food Markets in Guangzhou and Shenzhen, Guangdong, China: Implications for Public Health

    PubMed Central

    Gong, Shiping

    2014-01-01

    Sparganosis is a zoonotic disease caused by the spargana of Spirometra, and snake is one of the important intermediate hosts of spargana. In some areas of China, snake is regarded as popular delicious food, and such a food habit potentially increases the prevalence of human sparganosis. To understand the prevalence of Spirometra in snakes in food markets, we conducted a study in two representative cities (Guangzhou and Shenzhen), during January–August 2013. A total of 456 snakes of 13 species were examined and 251 individuals of 10 species were infected by Spirometra, accounting for 55.0% of the total samples. The worm burden per infected snake ranged from 1 to 213, and the prevalence in the 13 species was 0∼96.2%. More than half (58.1%) of the spargana were located in muscular tissue, 25.6% in subcutaneous tissue, and 16.3% in coelomic cavity. The results indicated that Spirometra severely infected snakes in food markets in Guangzhou and Shenzhen, implying that eating snakes has great health risk and improper cooking methods may increase the risk of Spirometra infection in humans in China. Additional steps should be considered by the governments and public health agencies to prevent the risk of snake-associated Spirometra infections in humans. PMID:24558340

  19. The phylogenetic diversity of Spirometra erinaceieuropaei isolates from southwest China revealed by multi genes.

    PubMed

    Zhang, Xi; Wang, Han; Cui, Jing; Jiang, Peng; Lin, Mei Long; Zhang, Yun Lu; Liu, Ruo Dan; Wang, Zhong Quan

    2016-04-01

    The larval plerocercoid of Spirometra erinaceieuropaei can parasitize humans, causing a serious food borne parasitic zoonosis known as sparganosis. Sparganosis have increased in China in recent years. In this study, the prevalence of sparganum infection in wild frogs in 9 geographical areas in southwest China was firstly investigated. Of 276 caught frogs, 55 frogs were found to be infected with sparganum. Then, the population genetic structure of these sparganum isolates was explored based on four molecular markers (cytb, cox1, rrnS and 28S rDNA D1). Highly genetic diversity and the genetic differentiation among sparganum isolates from different sites were revealed in the DNA polymorphism analyses. Both the phylogenetic inference and the analysis of the median-joining network supported two clades in the southwest S. erinaceieuropaei population. However, none demographic population expansion of the southwest S. erinaceieuropaei population was observed in the neutrality test, mismatch distribution analysis and Bayesian skyline plot analysis. Finally, the phylogenetic diversity of S. erinaceieuropaei from eastern, central, southern and southwest China was analyzed, the result suggested that Chinese S. erinaceieuropaei population should be divided into two groups (Group I and Group II), and they started to divergence in the middle Pliocene. PMID:26774686

  20. Characterisation of the relationship between Spirometra erinaceieuropaei and Diphyllobothrium species using complete cytb and cox1 genes.

    PubMed

    Zhang, Xi; Wang, Han; Cui, Jing; Jiang, Peng; Fu, Guo Mei; Zhong, Kan; Zhang, Zi Fang; Wang, Zhong Quan

    2015-10-01

    Spirometra erinaceieuropaei is an important diphyllobothriid cestode whose larval plerocercoid (sparganum) can parasitise humans, causing sparganosis. In China, sparganosis is an important foodborne parasitic zoonosis and poses a serious threat to human health. However, our knowledge of the taxonomic classification of S. erinaceieuropaei and its relationship with other diphyllobothriid cestodes, such as Diphyllobothrium, remains fragmentary. In this study, we determined the complete sequences of cytochrome b (cytb) and cytochrome c oxidase subunit I (cox1) genes from 61 isolates of S. erinaceieuropaei collected from 11 geographical locations in eastern China and compared them to the sequences of Diphyllobothrium species from the GenBank database. Then, we evaluated the genetic variation of S. erinaceieuropaei and the phylogenetic relationship between S. erinaceieuropaei and Diphyllobothrium. Both negative Tajima's D and Fu's FS values of neutrality tests and unimodal curve of mismatch distribution analyses supported demographic population expansion. Bayesian skyline plot (BSP) analyses indicated that a population expansion occurred in the Pleistocene. Phylogenetic analysis based on cytb, cox1, and cytb+cox1 under all three methods tested (neighbour-joining, maximum parsimony, and maximum likelihood) suggested that the S. erinaceieuropaei isolates from eastern China and the genus Diphyllobothrium are separate monophyletic groups. Furthermore, the uncorrelated log-normal relaxed molecular-clock model suggested that divergence between Spirometra and Diphyllobothrium began in the late Miocene. PMID:26205687

  1. Pentastomiasis and other parasitic zoonoses from reptiles and amphibians.

    PubMed

    Pantchev, Nikola; Tappe, Dennis

    2011-01-01

    Reptiles are growing in popularity as pets.The colonization of reptiles and amphibians by parasites and the resulting disease conditions are the most common problems seen in captive animals.This review focuses on pentastomiasis and sparganosis, important parasitic zoonoses of reptiles and amphibians, respectively, and free living-amoebae. Humans are suitable accidental hosts for some pentastomid species (particularly Armillifer and Porocephalus). In geographical areas with special ethnics, such as in West and Central Africa, and East Asia, 8-45% of the human population can be affected. Usually the larvae are coincidentally found during abdominal surgeries. However, fatalities have been described. Extreme caution is necessary when handling infected reptiles. Ocular or cerebral sparganosis is not uncommonly found in humans in East Asia. This disease is caused by spargana, tapeworm larvae (plerocercoids) of Spirometra sp. The infection occurs when uncooked meat from reptiles or amphibians is applied to wounds or eyes and the parasites migrate directly to human tissue, or by consumption of contaminated food or water. As a consequence of the reptile's predatory behaviour, the full spectrum of endo- and ectoparasites from potential prey animals can be found as transiting parasites in the intestinal tract, e. g. Hymenolepis nana, Cryptosporidium (C.) muris, C parvum or Capillaria hepatica. Occasionally, free-living amoebae are also found in reptile faeces (Acanthamoeba, Naegleria, Hartmanella, Vahlkampfia or Echinamoeba sp.). PMID:22191176

  2. Evolution of development in nematodes related to C. elegans.

    PubMed Central

    Sommer, Ralf J

    2005-01-01

    The knowledge about C. elegans provides a paradigm for comparative studies. Nematodes are very attractive in evolutionary developmental biology given the species richness of the phylum and the easiness with which several of these species can be cultured under laboratory conditions. Embryonic, gonad, vulva and male tail development were studied and compared in nematodes of five different families, providing a detailed picture of evolutionary changes in development. In particular, vulva development has been studied in great detail and substantial differences in the cellular, genetic and molecular mechanisms have been observed between C. elegans and other nematodes. For example, vulva induction relies on the single anchor cell in C. elegans, whereas a variety of different cellular mechanisms are used in related species. In recent years, a few species have been developed as satellite systems for detailed genetic and molecular studies, such as Oscheius tipulae and Pristionchus pacificus. PMID:18050392

  3. [Cystogenous nematode, Heterodera (Globodera) mali sp. n., an apple parasite in Kazakhstan].

    PubMed

    Kir'ianova, E S; Borisenko, A V

    1975-01-01

    There has been no information on cystogenous nematodes of the genus Heterodera injuring apple trees. The paper checks the first finding of these nematodes on the roots of a cultivated apple tree. The nematodes proved to be a new species, Heterodera mali sp. n. The apple cystogenous nematode resembles the potato cystogenous nematode H. rostochiensis Woll. in having a round body, small cleft of the vulva and similar sizes of eggs. It differs from H. rostochiensis in smaller sizes (on the average 5 against 9) very transparent and thin cuticle, a small distance between vulva and anus (on the average 43 against 86), a smaller value of the Granek's index (on the average 1.3 against 4.6), a smaller number of cuticular folds between vulva and anus (on the average 7 against 21) and different plant-hosts. A detailed description of H. mali sp. n. is given. PMID:130597

  4. Acute genital ulcers.

    PubMed

    Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora

    2014-01-01

    Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers. PMID:24473429

  5. The Mediator Kinase Module Restrains Epidermal Growth Factor Receptor Signaling and Represses Vulval Cell Fate Specification in Caenorhabditis elegans.

    PubMed

    Grants, Jennifer M; Ying, Lisa T L; Yoda, Akinori; You, Charlotte C; Okano, Hideyuki; Sawa, Hitoshi; Taubert, Stefan

    2016-02-01

    Cell signaling pathways that control proliferation and determine cell fates are tightly regulated to prevent developmental anomalies and cancer. Transcription factors and coregulators are important effectors of signaling pathway output, as they regulate downstream gene programs. In Caenorhabditis elegans, several subunits of the Mediator transcriptional coregulator complex promote or inhibit vulva development, but pertinent mechanisms are poorly defined. Here, we show that Mediator's dissociable cyclin dependent kinase 8 (CDK8) module (CKM), consisting of cdk-8, cic-1/Cyclin C, mdt-12/dpy-22, and mdt-13/let-19, is required to inhibit ectopic vulval cell fates downstream of the epidermal growth factor receptor (EGFR)-Ras-extracellular signal-regulated kinase (ERK) pathway. cdk-8 inhibits ectopic vulva formation by acting downstream of mpk-1/ERK, cell autonomously in vulval cells, and in a kinase-dependent manner. We also provide evidence that the CKM acts as a corepressor for the Ets-family transcription factor LIN-1, as cdk-8 promotes transcriptional repression by LIN-1. In addition, we find that CKM mutation alters Mediator subunit requirements in vulva development: the mdt-23/sur-2 subunit, which is required for vulva development in wild-type worms, is dispensable for ectopic vulva formation in CKM mutants, which instead display hallmarks of unrestrained Mediator tail module activity. We propose a model whereby the CKM controls EGFR-Ras-ERK transcriptional output by corepressing LIN-1 and by fine tuning Mediator specificity, thus balancing transcriptional repression vs. activation in a critical developmental signaling pathway. Collectively, these data offer an explanation for CKM repression of EGFR signaling output and ectopic vulva formation and provide the first evidence of Mediator CKM-tail module subunit crosstalk in animals. PMID:26715664

  6. Revision of the genus nacobbus thorne and allen, 1944 (nematoda: tylenchoidea).

    PubMed

    Sher, S A

    1970-07-01

    All four species and one subspecies of the genus Nacobbus Thorne and Allen, 1944 were studied and measured from type specimens. Nacobbus batatiformis Thorne and Schuster, 1956; N. serendipiticus Franklin, 1959; and N. serendipiticus bolivianus Lordello, Zamith and Boock, 1961 are proposed as synonyms of N. aberrans (Thorne, 1935) Tborne and Allen, 1944. Nacobbus aberrans is distinguished from the type species N. dorsalis Thcrne and Allen, 1944 by the larger number of body annules between the vulva and anus; the lower position of the vulva in the young female; and the shape and number of eggs retained in the mature female. PMID:19322302

  7. Revision of the Genus Nacobbus Thorne and Allen, 1944 (Nematoda: Tylenchoidea)

    PubMed Central

    Sher, S. A.

    1970-01-01

    All four species and one subspecies of the genus Nacobbus Thorne and Allen, 1944 were studied and measured from type specimens. Nacobbus batatiformis Thorne and Schuster, 1956; N. serendipiticus Franklin, 1959; and N. serendipiticus bolivianus Lordello, Zamith and Boock, 1961 are proposed as synonyms of N. aberrans (Thorne, 1935) Tborne and Allen, 1944. Nacobbus aberrans is distinguished from the type species N. dorsalis Thcrne and Allen, 1944 by the larger number of body annules between the vulva and anus; the lower position of the vulva in the young female; and the shape and number of eggs retained in the mature female. PMID:19322302

  8. Chikungunya

    MedlinePlus

    ... trasmitted by the same mosquitoes involved in the dengue transmision (Aedes aegypti and Aedes albopictus) ; also shares some clinical signs with dengue, and can be misdiagnosed in areas where dengue ...

  9. Fibula stress fracture mimicking a malignancy.

    PubMed

    Moussallem, Charbel D; El-Yahchouchi, Christine A; El-Khoury, Ziad N

    2010-01-01

    Stress fractures may be easily misdiagnosed as another entity, especially tumors, which may prompt very severe surgical treatment and sometimes amputation. The appropriate use of modern radiography may make the difference in proper diagnosis of stress fractures. PMID:20305842

  10. Iatrogenic Cushing's Disease in a Boy after Misdiagnosis of Salt-Losing Virilizing Adrenal Hyperplasia: Impaired Metyrapone Response with Failure of Catch-Up Growth

    ERIC Educational Resources Information Center

    Mendilaharzu, Hernan; And Others

    1973-01-01

    A boy misdiagnosed as having the sodium-losing form of virilizing adrenal hyperplasia was treated with large doses of glucocorticoids and mineralocorticoids from the newborn period until he was more than 4 years of age. (Author)

  11. Quit Obsessing!

    ERIC Educational Resources Information Center

    Schlozman, Steven C.

    2002-01-01

    Asserts the obsessive-compulsive disorder is often misdiagnosed in children and adolescents; describes characteristics of obsessive-compulsive disorder; differentiates between normal and abnormal obsessions; suggests ways teachers can help students diagnosed with the disorder. (PKP)

  12. Reye's Syndrome

    MedlinePlus

    ... the viral illness. RS is often misdiagnosed as encephalitis, meningitis, diabetes, drug overdose, poisoning, sudden infant death ... mask the symptoms of RS. Is there any treatment? There is no cure for RS. Successful management, ...

  13. Angelman Syndrome Foundation

    MedlinePlus

    ... of individuals with AS are originally misdiagnosed with cerebral palsy or autism, due to lack of awareness ... Contact Registry News For Parents Diagnosis Newly Diagnosed Contact Registry Participate in Research Studies ...

  14. Hepatic amebiasis: a reminder of the complications.

    PubMed

    Rao, Suchitra; Solaymani-Mohammadi, Shahram; Petri, William A; Parker, Sarah K

    2009-02-01

    The complications of amebic liver abscess are underappreciated in developed countries and are often misdiagnosed. We report a 16-month-old male child with amebic liver abscess, initially misdiagnosed with pneumonia, who became critically ill with peritoneal, pleural and pericardial extension, and gastric perforation. In addition to highlighting the complications of amebic liver abscess, this case demonstrates the value of PCR testing as a diagnostic and molecular tool. PMID:19242252

  15. ? integrin cytoplasmic tails can rescue the loss of Rho-family GTPase signaling in the C. elegans somatic gonad.

    PubMed

    Meighan, Christopher M; Kelly, Victoria E; Krahe, Elena C; Gaeta, Adriel J

    2015-05-01

    Integrin signaling relies on multiple, distinct pathways to impact a diverse set of cell behaviors. The Rho family of GTPases are well-established downstream signaling partners of integrins that regulate cell shape, polarity, and migration. The nematode C.elegans provides a simple in vivo system for studying both integrins and the Rho family. Our previous work showed that the C.elegans ? integrin cytoplasmic tails have tissue-specific functions during development. Here, we use chimeric ? integrins to show that the cytoplasmic tails can rescue the loss of the Rho family of GTPases in three cell types in the somatic gonad. Knockdown of rho-1 by RNAi causes defects in sheath cell actin organization, ovulation, and vulva morphology. Chimeric ? integrin ina-1 with the pat-2 cytoplasmic tail can rescue both actin organization and ovulation after rho-1 RNAi, yet cannot restore vulva morphology. Knockdown of cdc-42 by RNAi causes defects in sheath cell actin organization, ovulation, vulva morphology, and distal tip cell migration. Chimeric ? integrin pat-2 with the ina-1 cytoplasmic tail can rescue vulva morphology defects and distal tip cell migration after cdc-42 RNAi, yet cannot restore sheath cell actin organization or ovulation. Disruption of Rac yields the same phenotype in distal tip cells regardless of ? integrin cytoplasmic tail composition. Taken together, the cytoplasmic tails of ? integrins can bypass signaling from members of the Rho family of GTPases during development. PMID:25576691

  16. Characterization of a New Species of Cyst Nematode Parasitizing Corn

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Examination of soil around unthrifty corn roots in northwestern Tennessee (Obion County) in 2006 revealed high population densities of juvenile nematodes and lemon-shaped cysts. This nematode resembles Cactodera spp. in possessing a circumfenestrate vulva but lacking bullae and an underbridge. These...

  17. Sex pheromone in the dog.

    PubMed

    Goodwin, M; Gooding, K M; Regnier, F

    1979-02-01

    Methyl p-hydroxybenzoate has been identified in the vaginal secretions of female dogs in estrus. When small amounts of this compound were applied to the vulvas of anestrous or spayed females, males placed with these females became sexually aroused and attempted to mount them. PMID:569903

  18. Vaginal itching and discharge - Adult and adolescent

    MedlinePlus

    ... or thin Clear, cloudy, bloody, white, yellow, or green Odorless or have a bad odor Itching of the skin of the vagina and the surrounding area (vulva) may be present along with vaginal discharge. It can also occur on its own.

  19. Cáncer de vulva—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de vulva, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  20. On the description of two new species of Paurodontella (Nematoda: Paurodontinae) with a key and diagnostic compendium to the species of the genus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Two new species of Paurodontella collected around the roots of wheat (Triticum aestivum L.) are described and illustrated. One new species is characterized by having a short cylindrical, robust body markedly tapering at both ends with an anteriorly located vulva, short post-uterine sac, lateral fiel...

  1. Morphological and molecular characterization of Pratylenchus lentis n. sp. (Nematoda: Pratylenchidae) from Sicily

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pratylenchus lentis n. sp. parasitizing roots of lentil in Sicily, Italy, is described and illustrated. The new species is characterized by a high lip region with three annuli, stylet mean length of 16 micrometers with anteriorly flattened knobs, cylindrical body with a relatively anterior vulva, l...

  2. [Therapy for Angiokeratoma of Fordyce with the 940-nm Diode Laser].

    PubMed

    Meissner, M; Kaufmann, R

    2012-03-01

    This article reports on the effective and quick treatment of angioceratoma scroti sive vulvae Fordyce using a 940-nm diode laser. Up to now the usage of this laser has not been described for this indication and we show that it provides a successful therapeutic alternative with few side effects. PMID:22002010

  3. Urogenital tumors

    SciTech Connect

    Weller, R.E.

    1994-03-01

    An overview is provided for veterinary care of urogenital tumors in companion animals, especially the dog. Neoplasms discussed include tumors of the kidney, urinary bladder, prostate, testis, ovary, vagina, vulva and the canine transmissible venereal tumor. Topics addressed include description, diagnosis and treatment.

  4. 77 FR 64853 - Manual for Courts-Martial; Proposed Amendments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-23

    ... body or any object. (a) By force (i) That the accused committed a sexual act upon another person by... body or by any object; (ii) That the accused did so with unlawful force; and (iii) That the accused did... the vulva, anus, or mouth of another person by any part of the body or by any object; (ii) That...

  5. Evaluation of the Role of Vibrational Spectroscopy in the Assessment of Vulval Disease

    ClinicalTrials.gov

    2016-02-10

    Normal Vulval Skin; Lichen Sclerosus; High Grade Dysplasia - Usual Type ('VIN 2-3'); High Grade Dysplasia - Differentiated Type ('VIN 2-3'); Squamous Cell Carcinoma; Epithelial Hyperplasia Without Atypia; Atypia Not Otherwise Specified/ Low Grade Dysplasia ('VIN 1'); Pagets Disease of the Vulva

  6. Genetic control of vulval development in Caenorhabditis briggsae.

    PubMed

    Sharanya, Devika; Thillainathan, Bavithra; Marri, Sujatha; Bojanala, Nagagireesh; Taylor, Jon; Flibotte, Stephane; Moerman, Donald G; Waterston, Robert H; Gupta, Bhagwati P

    2012-12-01

    The nematode Caenorhabditis briggsae is an excellent model organism for the comparative analysis of gene function and developmental mechanisms. To study the evolutionary conservation and divergence of genetic pathways mediating vulva formation, we screened for mutations in C. briggsae that cause the egg-laying defective (Egl) phenotype. Here, we report the characterization of 13 genes, including three that are orthologs of Caenorhabditis elegans unc-84 (SUN domain), lin-39 (Dfd/Scr-related homeobox), and lin-11 (LIM homeobox). Based on the morphology and cell fate changes, the mutants were placed into four different categories. Class 1 animals have normal-looking vulva and vulva-uterine connections, indicating defects in other components of the egg-laying system. Class 2 animals frequently lack some or all of the vulval precursor cells (VPCs) due to defects in the migration of P-cell nuclei into the ventral hypodermal region. Class 3 animals show inappropriate fusion of VPCs to the hypodermal syncytium, leading to a reduced number of vulval progeny. Finally, class 4 animals exhibit abnormal vulval invagination and morphology. Interestingly, we did not find mutations that affect VPC induction and fates. Our work is the first study involving the characterization of genes in C. briggsae vulva formation, and it offers a basis for future investigations of these genes in C. elegans. PMID:23275885

  7. Genetic Control of Vulval Development in Caenorhabditis briggsae

    PubMed Central

    Sharanya, Devika; Thillainathan, Bavithra; Marri, Sujatha; Bojanala, Nagagireesh; Taylor, Jon; Flibotte, Stephane; Moerman, Donald G.; Waterston, Robert H.; Gupta, Bhagwati P.

    2012-01-01

    The nematode Caenorhabditis briggsae is an excellent model organism for the comparative analysis of gene function and developmental mechanisms. To study the evolutionary conservation and divergence of genetic pathways mediating vulva formation, we screened for mutations in C. briggsae that cause the egg-laying defective (Egl) phenotype. Here, we report the characterization of 13 genes, including three that are orthologs of Caenorhabditis elegans unc-84 (SUN domain), lin-39 (Dfd/Scr-related homeobox), and lin-11 (LIM homeobox). Based on the morphology and cell fate changes, the mutants were placed into four different categories. Class 1 animals have normal-looking vulva and vulva-uterine connections, indicating defects in other components of the egg-laying system. Class 2 animals frequently lack some or all of the vulval precursor cells (VPCs) due to defects in the migration of P-cell nuclei into the ventral hypodermal region. Class 3 animals show inappropriate fusion of VPCs to the hypodermal syncytium, leading to a reduced number of vulval progeny. Finally, class 4 animals exhibit abnormal vulval invagination and morphology. Interestingly, we did not find mutations that affect VPC induction and fates. Our work is the first study involving the characterization of genes in C. briggsae vulva formation, and it offers a basis for future investigations of these genes in C. elegans. PMID:23275885

  8. Protocylindrocorpus dendrophilus n. sp. (Nematoda: Cylindrocorpidae) Associated with Pine Wood Borings.

    PubMed

    Kinn, D N

    1984-04-01

    Protocylindrocorpus dendrophilus n. sp. is described from xylem samples taken from beetle infested slash pine (Pinus elliottii Engelmann var. elliottii) in Central Louisiana. It is similar to P. goodeyi (Rühm) Paramonov, but differs by the possession of a protuberant and more posteriorly located vulva and in the position of the caudal papillae. Morphometrics of the male and female are presented. PMID:19295889

  9. Human papillomavirus-associated cancers: A growing global problem.

    PubMed

    Bansal, Anshuma; Singh, Mini P; Rai, Bhavana

    2016-01-01

    Human papillomavirus (HPV) infection is linked with several cancers such as cancer cervix, vagina, vulva, head and neck, anal, and penile carcinomas. Although there is a proven association of HPV with these cancers, questions regarding HPV testing, vaccination, and treatment of HPV-related cancers continue to remain unanswered. The present article provides an overview of the HPV-associated cancers. PMID:27127735

  10. Human papillomavirus-associated cancers: A growing global problem

    PubMed Central

    Bansal, Anshuma; Singh, Mini P; Rai, Bhavana

    2016-01-01

    Human papillomavirus (HPV) infection is linked with several cancers such as cancer cervix, vagina, vulva, head and neck, anal, and penile carcinomas. Although there is a proven association of HPV with these cancers, questions regarding HPV testing, vaccination, and treatment of HPV-related cancers continue to remain unanswered. The present article provides an overview of the HPV-associated cancers. PMID:27127735

  11. Traumatic Vulvar Epithelial Inclusion Cysts Following Female Genital Mutilation (FGM)

    PubMed Central

    Mack-Detlefsen, B.; Banaschak, S.; Boemers, T. M.

    2015-01-01

    Background: Female genital mutilation (FGM) occurs mainly in Africa, parts of the Arabian Peninsula and parts of Asia. It is commonly associated with acute complications as well as diverse late/delayed complications. One of the most common of these late complications is progressively enlarging painless cysts of the vulva. Case Report: An 8-year-old girl from Eritrea presented to our paediatric emergency department with a progressively enlarging mass of the vulva. She had undergone a clitoridectomy and partial removal of the labia minora as an infant in Eritrea. We performed surgical excision of the cyst and reconstruction of the labia. Histology showed a traumatic squamous epithelial inclusion cyst of the vulva. Conclusion: Epithelial or dermoid cysts of the vulva following FGM are extremely rare. Symptoms often require surgical intervention. Through increasing migration, more girls and female youths with FGM are likely to present to practices and hospitals in Germany. Thus increased knowledge and awareness of the medical complications of FGM and their treatment will be necessary in years to come. PMID:26500372

  12. Cáncer de vulva—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de vulva, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  13. Eosinophilic pleuritis due to sparganum: a case report.

    PubMed

    Oh, Youngmin; Kim, Jeong-Tae; Kim, Mi-Kyeong; Chang, You-Jin; Eom, Keeseon; Park, Jung-Gi; Lee, Ki-Man; Choe, Kang-Hyeon; An, Jin-Young

    2014-10-01

    Sparganosis is a rare parasitic disease caused by migrating plerocercoid tapeworm larva of the genus Spirometra. Infection in humans is mainly caused by the ingestion of raw or inadequately cooked flesh of infected frogs, snakes, and chickens. Here, we report a rare case of a 45-year-old man who was admitted to our hospital with left lower chest pain. The chest radiograph and computed tomography (CT) scan revealed localized pleural effusion in the left lower lobe; further, peripheral blood eosinophilia and eosinophilic pleural effusion were present. Percutaneous catheter drainage was performed, which revealed long worm-shaped material that was identified as a sparganum by DNA sequencing. The patient showed clinical improvement after drainage of the sparganum. This study demonstrates the importance of considering parasitic diseases in the differential diagnosis of eosinophilic pleural effusion. PMID:25352705

  14. Mucocutaneous manifestations of helminth infections: Trematodes and cestodes.

    PubMed

    Lupi, Omar; Downing, Christopher; Lee, Michael; Bravo, Francisco; Giglio, Patricia; Woc-Colburn, Laila; Tyring, Stephen K

    2015-12-01

    In the 21st century, despite increased international travel for vacation, work, and medical missions and immigration into the United States, there is little published in the dermatology literature regarding the cutaneous manifestations of helminth infections. It has been estimated that 20% to 70% of international travelers suffer from some travel-related health problem. Approximately 17% of travelers seek medical care because of cutaneous disorders, many related to infectious etiologies. This review will focus on cutaneous diseases caused by helminth infections. Part I of the review focused on nematode infections; part II will focus on trematode and cestode infections. Nematodes are roundworms that cause diseases with cutaneous manifestations, such as cutaneous larval migrans, onchocerciasis, filariasis, gnathostomiasis, loiasis, dracunculiasis, strongyloidiasis, ascariasis, streptocerciasis, dirofilariasis, and trichinosis. Tremadotes, also known as flukes, cause schistosomiasis, paragonimiasis, and fascioliasis. Cestodes (tapeworms) are flat, hermaphroditic parasites that cause diseases such as sparganosis, cysticercosis, and echinococcus. PMID:26568338

  15. Mucocutaneous manifestations of helminth infections: Nematodes.

    PubMed

    Lupi, Omar; Downing, Christopher; Lee, Michael; Pino, Livia; Bravo, Francisco; Giglio, Patricia; Sethi, Aisha; Klaus, Sidney; Sangueza, Omar P; Fuller, Claire; Mendoza, Natalia; Ladizinski, Barry; Woc-Colburn, Laila; Tyring, Stephen K

    2015-12-01

    In the 21st century, despite increased globalization through international travel for business, medical volunteerism, pleasure, and immigration/refugees into the United States, there is little published in the dermatology literature regarding the cutaneous manifestations of helminth infections. Approximately 17% of travelers seek medical care because of cutaneous disorders, many related to infectious etiologies. This review will focus on the cutaneous manifestations of helminth infections and is divided into 2 parts: part I focuses on nematode infections, and part II focuses on trematode and cestode infections. This review highlights the clinical manifestations, transmission, diagnosis, and treatment of helminth infections. Nematodes are roundworms that cause diseases with cutaneous manifestations, such as cutaneous larval migrans, onchocerciasis, filariasis, gnathostomiasis, loiasis, dracunculiasis, strongyloidiasis, ascariasis, streptocerciasis, dirofilariasis, and trichinosis. Tremadotes, also known as flukes, cause schistosomiasis, paragonimiasis, and fascioliasis. Cestodes (tapeworms) are flat, hermaphroditic parasites that cause diseases such as sparganosis, cysticercosis, and echinococcus. PMID:26568337

  16. Using community surveillance data to differentiate between emerging and endemic amphibian diseases.

    PubMed

    Young, Sam; Skerratt, Lee F; Mendez, Diana; Speare, Rick; Berger, Lee; Steele, Mike

    2012-02-17

    We analyzed submission data from a wildlife care group during amphibian disease surveillance in Queensland, Australia. Between January 1999 and December 2004, 877 white-lipped tree frogs Litoria infrafrenata were classified according to origin, season and presenting category. At least 69% originated from urban Cairns, significantly more than from rural and remote areas. Total submissions increased during the early and late dry seasons compared with the early wet season. Frogs most commonly presented each year with injury, followed by 'other', sparganosis and irreversible emaciation of unknown aetiology. This is the first report of Spirometra erinacei infection in this species. A high prevalence (28%) of visible S. erinacei infection was found in emaciated frogs, but this was not statistically different from that in non-emaciated diseased frogs (25%). However, 14 emaciated specimens that were necropsied all had heavy S. erinacei infections, and the odds of visible sparganosis were statistically greater in emaciated frogs compared with injured, non-diseased frogs. We provide a detailed case definition for a new endemic disease manifesting as irreversible emaciation, for which S. erinacei may be the primary aetiological agent. The lack of significant spatial or temporal patterns in case presentation suggests that this is not a currently emerging disease. We show that community wildlife groups can play a valuable role in monitoring disease trends, particularly in urban areas, but identify a number of limitations associated with passive syndromic surveillance. We conclude that it is critical that professionals be involved in establishing syndromic case definitions, diagnostic pathology, complementary active disease surveillance, and data analysis and interpretation in all wildlife disease investigations. PMID:22422125

  17. Effects of Feeding Barley Naturally Contaminated with Fusarium Mycotoxins on Growth Performance, Nutrient Digestibility, and Blood Chemistry of Gilts and Growth Recoveries by Feeding a Non-contaminated Diet.

    PubMed

    Kong, C; Shin, S Y; Park, C S; Kim, B G

    2015-05-01

    The objectives of this study were to investigate the effects of feeding barley naturally contaminated with Fusarium mycotoxins on growth performance, vulva swelling, and digestibility of dry matter, organic matter, and crude protein of gilts and the recovery of gilts fed normal diets immediately after the exposure to contaminated diets by measuring growth performance and vulva swelling. In Exp. 1, four diets were prepared to contain 0%, 15%, 30%, or 45% contaminated barley containing 25.7 mg/kg deoxynivalenol and 26.0 μg/kg zearalenone. Sixteen gilts with an initial body weight (BW) of 33.3 kg (standard deviation = 3.0) were individually housed in a metabolism crate and assigned to 4 diets with 4 replicates in a randomized complete block design based on BW. During the 14-d feeding trial, individual BW and feed consumption were measured weekly and the vertical and horizontal lengths of vulva were measured every 3 d. From d 10, feces were collected by the maker-to-marker method for 4 d. Blood samples were collected on d 14. During the overall period, the average daily gain, average daily feed intake, and gain:feed of pigs linearly decreased (p<0.01) as the dietary concentration of contaminated barley increased. However, the digestibility of crude protein was linearly increased (p = 0.011) with the increasing amounts of contaminated barley. Increasing dietary Fusarium mycotoxin concentrations did not influence vulva size, blood characteristic as well as immunoglobulin level of pigs. In the Exp. 2, a corn-soybean meal-based diet was formulated as a recovery diet. Pigs were fed the recovery diet immediately after completion of the Exp. 1. During the 14-d of recovery period, the individual BW and feed consumption were measured weekly and the vertical and horizontal length of vulva were measured every 3 d from d 0. On d 7, the feed intake of pigs previously fed contaminated diets already reached that of pigs fed a diet with 0% contaminated barley and no significant difference in growth performance among treatments was observed during d 7 to 14 of the recovery period. In conclusion, increasing levels of mycotoxins in diets linearly decreased the growth performance of pigs, and these damages can be recovered in 7 d after the diet was replaced with a normal diet. The vulva size, blood characteristic, immune responses were not affected by increasing level of contaminated barley in the diets fed to pigs. PMID:25715687

  18. Effects of Feeding Barley Naturally Contaminated with Fusarium Mycotoxins on Growth Performance, Nutrient Digestibility, and Blood Chemistry of Gilts and Growth Recoveries by Feeding a Non-contaminated Diet

    PubMed Central

    Kong, C.; Shin, S. Y.; Park, C. S.; Kim, B. G.

    2015-01-01

    The objectives of this study were to investigate the effects of feeding barley naturally contaminated with Fusarium mycotoxins on growth performance, vulva swelling, and digestibility of dry matter, organic matter, and crude protein of gilts and the recovery of gilts fed normal diets immediately after the exposure to contaminated diets by measuring growth performance and vulva swelling. In Exp. 1, four diets were prepared to contain 0%, 15%, 30%, or 45% contaminated barley containing 25.7 mg/kg deoxynivalenol and 26.0 μg/kg zearalenone. Sixteen gilts with an initial body weight (BW) of 33.3 kg (standard deviation = 3.0) were individually housed in a metabolism crate and assigned to 4 diets with 4 replicates in a randomized complete block design based on BW. During the 14-d feeding trial, individual BW and feed consumption were measured weekly and the vertical and horizontal lengths of vulva were measured every 3 d. From d 10, feces were collected by the maker-to-marker method for 4 d. Blood samples were collected on d 14. During the overall period, the average daily gain, average daily feed intake, and gain:feed of pigs linearly decreased (p<0.01) as the dietary concentration of contaminated barley increased. However, the digestibility of crude protein was linearly increased (p = 0.011) with the increasing amounts of contaminated barley. Increasing dietary Fusarium mycotoxin concentrations did not influence vulva size, blood characteristic as well as immunoglobulin level of pigs. In the Exp. 2, a corn-soybean meal-based diet was formulated as a recovery diet. Pigs were fed the recovery diet immediately after completion of the Exp. 1. During the 14-d of recovery period, the individual BW and feed consumption were measured weekly and the vertical and horizontal length of vulva were measured every 3 d from d 0. On d 7, the feed intake of pigs previously fed contaminated diets already reached that of pigs fed a diet with 0% contaminated barley and no significant difference in growth performance among treatments was observed during d 7 to 14 of the recovery period. In conclusion, increasing levels of mycotoxins in diets linearly decreased the growth performance of pigs, and these damages can be recovered in 7 d after the diet was replaced with a normal diet. The vulva size, blood characteristic, immune responses were not affected by increasing level of contaminated barley in the diets fed to pigs. PMID:25715687

  19. Migraine misdiagnosis as a sinusitis, a delay that can last for many years

    PubMed Central

    2013-01-01

    Background Sinusitis is the most frequent misdiagnosis given to patients with migraine. Therefore we decided to estimate the frequency of misdiagnosis of sinusitis among migraine patients. Methods The study included migraine patients with a past history of sinusitis. All included cases fulfilled the International Classification of Headache Disorders, 3rd edition (ICHD-III- beta) criteria. We excluded patients with evidence of sinusitis within the past 6 months of evaluation. Demographic data, headache history, medical consultation, and medication intake for headache and effectiveness of therapy before and after diagnosis were collected. Results A total of 130 migraine patients were recruited. Of these patients 106 (81.5%) were misdiagnosed as sinusitis. The mean time delay of migraine diagnosis was (7.75 ± 6.29, range 1 to 38 years). Chronic migraine was significantly higher (p < 0.02) in misdiagnosed patients than in patients with proper diagnosis. Medication overuse headache (MOH) was reported only in patients misdiagnosed as sinusitis. The misdiagnosed patients were treated either medically 87.7%, or surgically12.3% without relieve of their symptoms in 84.9% and 76.9% respectively. However, migraine headache improved in 68.9% after proper diagnosis and treatment. Conclusions Many migraine patients were misdiagnosed as sinusitis. Strict adherence to the diagnostic criteria will prevent the delay in migraine diagnosis and help to prevent chronification of the headache and possible MOH. PMID:24330723

  20. A rare case of vulval pilonidal sinus: incidental diagnosis.

    PubMed

    Kushwaha, P; Merritt, A; Aslam, M B

    2015-01-01

    A 63-year-old woman presented with a 4-week history of vulval bleeding. On examination, an 8 mm fleshy irregular vascular lesion was present on the vulva in the periclitoreal area. This vulval lesion was treated by surgical excision. Histological analysis showed irregular pieces of skin partly covered by hyperplastic squamous epithelium. There were areas of fistulous-like endophytic proliferations lined by hyperplastic squamous epithelial cells. The intervening stroma showed granulation tissue with severe active chronic inflammation. At least five hair follicle shafts surrounded by foreign body type giant cells were also identified within the inflamed area. There was no evidence of dysplasia or malignancy. This chronically inflamed fistulous tract together with hair shafts within the wall of the tract were diagnostic of a pilonidal sinus of the vulva. This case report summarises the importance of diagnosing pilonidal sinus at an unusual location. PMID:26216921

  1. Polarization dependant in vivo second harmonic generation imaging of Caenorhabditis elegans vulval, pharynx, and body wall muscles

    NASA Astrophysics Data System (ADS)

    Psilodimitrakopoulos, Sotiris; Santos, Susana; Amat-Roldan, Ivan; Mathew, Manoj; Thayil K. N., Anisha; Artigas, David; Loza-Alvarez, Pablo

    2008-02-01

    Second harmonic generation (SHG) imaging has emerged in recent years as an important laboratory imaging technique since it can provide unique structural information with submicron resolution. It enjoys the benefits of non-invasive interaction establishing this imaging modality as ideal for in vivo investigation of tissue architectures. In this study we present, polarization dependant high resolution SHG images of Caenorhabditis elegans muscles in vivo. We imaged a variety of muscular structures such as body walls, pharynx and vulva. By fitting the experimental data into a cylindrical symmetry spatial model we mapped the corresponding signal distribution of the χ (2) tensor and identified its main axis orientation for different sarcomeres of the earth worm. The cylindrical symmetry was considered to arise from the thick filaments architecture of the inside active volume. Moreover, our theoretical analysis allowed calculating the mean orientation of harmonophores (myosin helical pitch). Ultimately, we recorded and analysed vulvae muscle dynamics, where SHG signal decreased during in vivo contraction.

  2. DOP-2 D2-Like Receptor Regulates UNC-7 Innexins to Attenuate Recurrent Sensory Motor Neurons during C. elegans Copulation

    PubMed Central

    Correa, Paola A.; Gruninger, Todd

    2015-01-01

    Neuromodulation of self-amplifying circuits directs context-dependent behavioral executions. Although recurrent networks are found throughout the Caenorhabditis elegans connectome, few reports describe the mechanisms that regulate reciprocal neural activity during complex behavior. We used C. elegans male copulation to dissect how a goal-oriented motor behavior is regulated by recurrently wired sensory-motor neurons. As the male tail presses against the hermaphrodite's vulva, cholinergic and glutamatergic reciprocal innervations of post cloaca sensilla (PCS) neurons (PCA, PCB, and PCC), hook neurons (HOA, HOB), and their postsynaptic sex muscles execute rhythmic copulatory spicule thrusts. These repetitive spicule movements continue until the male shifts off the vulva or genital penetration is accomplished. However, the signaling mechanism that temporally and spatially restricts repetitive intromission attempts to vulva cues was unclear. Here, we report that confinement of spicule insertion attempts to the vulva is facilitated by D2-like receptor modulation of gap-junctions between PCB and the hook sensillum. We isolated a missense mutation in the UNC-7(L) gap-junction isoform, which perturbs DOP-2 signaling in the PCB neuron and its electrical partner, HOA. The glutamate-gated chloride channel AVR-14 is expressed in HOA. Our analysis of the unc-7 mutant allele indicates that when DOP-2 promotes UNC-7 electrical communication, AVR-14-mediated inhibitory signals pass from HOA to PCB. As a consequence, PCB is less receptive to be stimulated by its recurrent synaptic partner, PCA. Behavioral observations suggest that dopamine neuromodulation of UNC-7 ensures attenuation of recursive intromission attempts when the male disengages or is dislodged from the hermaphrodite genitalia. SIGNIFICANCE STATEMENT Using C. elegans male copulation as a model, we found that the neurotransmitter dopamine stimulates D2-like receptors in two sensory circuits to terminate futile behavioral loops. The D2-like receptors promote inhibitory electrical junction activity between a chemosensory and a mechanosensory circuit. Therefore, both systems are attenuated and the animal ceases the recursive behavior. PMID:26156999

  3. Vulvar lymphangioma circumscriptum: a rare complication of therapy for squamous cell carcinoma of the cervix

    SciTech Connect

    LaPolla, J.; Foucar, E.; Leshin, B.; Whitaker, D.; Anderson, B.

    1985-11-01

    The clinical and pathological features of a case of multifocal lymphangioma circumscriptum of the vulva are reported in a patient with chronic lymphedema of a lower extremity. Ten years previously the patient had been treated for squamous cell carcinoma of the cervix. Although lymphangioma circumscriptum is an extremely rare complication of altered lymphatic drainage, the presence of multiple noninflammatory vesicular appearing lesions in this setting should suggest the correct diagnosis.

  4. Vulvar Dermatoses: A Review and Update.

    PubMed

    Simonetta, Cassandra; Burns, Erin K; Guo, Mary A

    2015-01-01

    The purpose of this article is to review six important inflammatory dermatoses of the vulva and to update readers on the new advancements in treatment of these mucosal conditions. Psoriasis, lichen sclerosis, lichen simplex chronicus and lichen planus are common vulvar conditions that cause pruritis and/or pain. PIasma cell vulvitis and desquamative inflammatory vaginitis are rare and challenging to be recognized, which often remain undiagnosed. PMID:26455062

  5. [Saforelle - a new approach to treat vaginitis].

    PubMed

    Karamisheva, V; Nachev, A

    2015-01-01

    Infections of the vulva and vagina are one of the most common gynecological diseases. They can be determined by a variety of physical, chemical and biological factors. The main risk factors contributing to vaginitis are aerobic and anaerobic bacterias, fungal and viral infections, and irritants. Subjective complaints are pruritus, vulvar and/or perivulvar erytema and different in volume and characterization discharge. Excepting etiological treatment in most cases it is necessary to use additional agents, for example Saforelle. PMID:26817249

  6. Description of Distorhabditis poonchiana n. gen., n. sp. (Nematoda: Rhabditidae) from Jammu and Kashmir, India

    PubMed Central

    Shah, Ali Asghar; Vaid, Shavish; Hussain, Abid; Ahmad, Rakeeb

    2015-01-01

    Distorhabditis poonchiana n. gen., n. sp. from humus in Jammu and Kashmir, India, is described and illustrated. The new genus is characterized by a small body; slightly setoff labial region; long tubular gymnostom; prominently cuticularized cheilostom; absence of glottoid apparatus; monoprodelphic reproductive system; vulva (V) = 81 to 84; spicules with trifurcated distal ends, simple gubernaculum, peloderan bursa with eight pairs of bursal papillae arranged in 1 + 1 + 1 + 2 + 1 + 2 arrangement. PMID:26941466

  7. Successful treatment of genital Bowen's disease with imiquimod 5% cream.

    PubMed

    Kishi, Chikako; Shimizu, Akira; Kato, Madoka; Amano, Hiroo; Ishikawa, Osamu

    2015-09-01

    A 64-year-old Japanese woman was diagnosed as having Bowen's disease on the vulva. The histopathological findings revealed papillomatosis, koilocytosis and clumping cells with atypical nuclei. Human papillomavirus DNA was not detected on polymerase chain reaction using consensus primers. The lesion was successfully treated with topical imiquimod 5% cream after two months. Histopathologically, no atypical cells were observed after treatment. Imiquimod can be a potential treatment modality for lesions that are difficult to treat with surgical excision. PMID:25258393

  8. Management of Extramammary Paget's Disease: A Case Report and Review of the Literature

    PubMed Central

    2013-01-01

    Extramammary Paget's Disease (EMPD) is a rare condition of the skin that often involves the vulva, perianal region, scrotum, penis, and axilla. Although prognosis is generally favorable, it can be associated with neoplasms of the bladder, urethra, prostate, and rectum. This report presents a case of scrotal EMPD that failed treatment with imiquimod 5% cream and discusses benefits and complications of available treatment options. The variation of treatment success emphasizes the importance of further research. PMID:24349803

  9. Genital pathology: its impact on the interpretation of signs of genital trauma (SEAL development training).

    PubMed

    Walter, H

    1998-06-01

    A seminar was held in October 1997 at Wood Street Police Station by courtesy of the City of London Police to explore the diagnostic difficulties posed by pathological conditions affecting the vulva and penis, which may cause problems when assessing the nature and degree of genital injury in allegations of sexual assault. While a lot of the presentations were visual, in the form of slides of the discussed conditions, a synopsis of each speaker's contribution is given below. PMID:15335545

  10. Perineal template techniques for interstitial implantation of gynecological cancers using the Paris system of dosimetry

    SciTech Connect

    Leung, S. )

    1990-09-01

    Since 1984, perineal template/needle techniques for interstitial implantation of gynecologic cancer-cervix, vagina, vulva-have been developed at the Peter MacCallum Cancer Institute. The Paris System of dosimetry has been used resulting in greater dose homogeneity, fewer needles and radioactive sources and considerable simplification and ease of implantation compared with comparable techniques developed in the United States. Principles and techniques of implantation are described in detail.

  11. Surgical treatment of invasive vulvar cancer.

    PubMed

    Pantelic, Milos; Durdević, Srdan; Nikolić, Dragan; Maksimović, Marko

    2012-01-01

    This paper presents the surgical treatment of invasive cancer of the vulva at the Department of Gynecology and Obstetrics inNovi Sad in the period from 2000 to 2010. Forty-one patients underwent different surgical procedures depending on their stage of the disease, age and general physical condition assessed according to the International Federation of Gynecologists and Obstetricians: wide excision to the healthy area with negative edges of 10 mm, simplex--radical vulvectomy or hemivulvectomy, block dissection of the vulva by Way, one-sided or bilateral lymphadenectomy and skin-muscle flap to cover the resulting skin defects. The number of removed lymph nodes on one side ranged from 8 to 19, the average being 12.6. Various postoperative complications (inflammation and wound dehiscence, lymphorrhoea, lymphocyst and limb lymphedema) developed in 9 (21.9%) and the local regional recurrence was recorded in 7 (17%) patients. The outcome was lethal in 4 (9.8%) surgically treated women. The primary surgical procedure is always individually planned and the choice of individual plans depends on three main factors: the size and position of the primary tumor in relation to the center line of the vulva (clitoral area--anus) and the involvement of regional lymph nodes. In order to reduce the psychosexual morbidity the preference is nowadays widely given to the local excision with adequate and histopathologically confirmed negative edges of the tumor together with determining the presence of metastases in sentinel lymph nodes. PMID:22788055

  12. [Vulvar melanoma].

    PubMed

    Chokoeva, A; Tchernev, G; Wollina, U

    2015-01-01

    Malignant melanoma of the vulva is a rare disease with aggressive behavior and poor prognosis. It consist < 5% of all cases of melanoma in females, as the ratio of its manifestation, compared with the cutaneous melanoma is 1:71. Higher risk of developing melanoma of the vulva is established in white women, as the peak of the incidence is between 60 and 70 years of age. Clinically, MM of the vulva manifests as asymptomatic pigmented, rarely a pigmented lesion, as the usual clinical form is superficial spreading MM and much less common nodular MM, which is associated with a poorer prognosis in. general. The diagnosis is confirmed by histological examination. Conduction of PCR and DNA analysis for detection of BRAF mutations, NRAS mutations and KIT amplification is also appropriate. Advanced age, black race, tumor size, tumor thickness, ulceration, presence of satellite lesions, involvement of adjacent organs (vagina, urethra), and the presence of regional or distant metastases are identified as the most important prognostic markers. Radical wide excision followed by bilateral lymphadenectomy id considered as the optimal therapeutic approach. PMID:25909143

  13. Influence of menstruation on the microbiota of healthy women's labia minora as analyzed using a 16S rRNA gene-based clone library method.

    PubMed

    Shiraishi, Tsukasa; Fukuda, Kazumasa; Morotomi, Nobuo; Imamura, Yuri; Mishima, Junko; Imai, Shigeo; Miyazawa, Kiyoshi; Taniguchi, Hatsumi

    2011-01-01

    The aim of this study was to determine the influence of menstruation on the bacterial population of healthy Japanese women's vulvas, especially the labia minora. Labia minora swabs were obtained from 10 premenopausal, nonpregnant Japanese women at premenstruation and on day 2 of menstruation. Vaginal swabs were also obtained from 3 out of the 10 women. No significant difference was found in the average bacterial cell count between the menstruation and premenstruation samples. Molecular analysis using a 16S rRNA gene-based clone library method detected 22 genera from the labia minora swabs (total 20), with the genus Lactobacillus being predominant at both premenstruation and during menstruation in 7 out of the 10 women. Of the other 3 women, 2 showed various kinds of bacterial species, including oral and fecal bacteria, with Atopobium vaginae and Gardnerella vaginalis predominating in the remaining woman's vulva in both conditions. In total, 6 out of 10 cases (60%) showed significantly different microbiota of the labia minora between the two conditions. These results imply that menstruation may promote a distortion of the bacterial flora around the vulva, although it causes no significant increase of the bacterial count. PMID:21266747

  14. Facial Involuntary Movements and Respiratory Failure in CANOMAD, Responsive to IVIG Therapy

    PubMed Central

    Johnson, Kate; Malkan, Ashish; Shaffi, Mohamed

    2015-01-01

    CANOMAD is a rare chronic neuropathy, characterized by chronic sensory ataxia and intermittent brain stem symptoms due to antidisialosyl antibodies. The disorder results in significant morbidity but is poorly understood and often misdiagnosed. We describe a unique case of CANOMAD, associated with involuntary movements of the face; patient reported exacerbations with citrus and chocolate and respiratory muscle weakness. Our patient was initially misdiagnosed with Miller Fisher Syndrome, highlighting the need for vigilance should neurological symptoms recur in patients initially diagnosed with a Guillain Barre variant. Moreover, the optimal treatment is unknown. This patient responded remarkably to intravenous immunoglobulin and has been maintained on this treatment, without further exacerbations. PMID:26697071

  15. Perioral dermatitis -- the role of nasal steroids.

    PubMed

    Peralta, Lígia; Morais, Paulo

    2012-06-01

    We present two patients with allergic rhinitis who developed perioral dermatitis (PD) after initiating intranasal steroid spray. Both patients had been previously misdiagnosed as having contact or seborrheic dermatitis, and therefore inappropriately and unsuccessfully treated with topical steroids. Physicians should be aware of this potential side effect of intranasal steroids to avoid incorrect therapeutic measures. In the setting of nasal steroids use, PD probably is an under-reported and commonly misdiagnosed condition that should be thought when a patient treated with nasal steroids present with small erythematous papules, papulovesicles, and papulopustules occurring against a background of redness, beginning in the nasolabial areas and spreading rapidly to the perioral zone. PMID:21995785

  16. Cleidocranial dysplasia syndrome (CCD) with an unusual finding in a young patient.

    PubMed

    Singhal, Parul; Singhal, Anita; Jayam, Cheranjeevi; Bandlapalli, Anila

    2015-01-01

    Cleidocranial dysplasia (CCD), an autosomal dominant disorder with a prevalence of 1 in 1,000,000 individuals, presents with a wide range of variability. Dentists are often the first to encounter patients with CCD, some of whom do not show typical manifestations. Since it has similar features to other pathologies, CCD is misdiagnosed as other conditions. A 10-year-old boy suffering from CCD was misdiagnosed as having rickets and was referred for non-eruption of a few permanent teeth along with an unaesthetic facial appearance. Clinically and radiologically, a diagnosis of CCD was made. Currently, management of this patient's orofacial manifestations is underway. PMID:26581700

  17. Diarrhea as initial manifestation of pulmonary artery intimal sarcoma: a case report and literature review

    PubMed Central

    Xu, Xiaoling; Zhang, Ruifeng; Hu, Huihui; Ye, Wu; Wang, Jin; Chen, Liying; Qiu, Lijun; Ying, Kejing

    2015-01-01

    Pulmonary artery intimal sarcoma (PAIS) is a rare malignant tumor that presents with nonspecific symptoms and may be misdiagnosed as thromboembolic disease. We report a case of a 40-year-old female who presented with diarrhea as the initial symptom, was misdiagnosed and received thrombolytic therapy for presumed pulmonary embolism. Progressive symptoms and subsequent surgery led to the diagnosis of PAIS, and early relapse after pulmonary endarterectomy. Her survival time was 17 months after pulmonary endarterectomy. To our knowledge, diarrhea as initial manifestation of PAIS has not been described. PMID:26425101

  18. Chondroblastoma-like osteosarcoma: a case report and review.

    PubMed

    Aycan, Osman Emre; Vanel, Daniel; Righi, Alberto; Arikan, Yavuz; Manfrini, Marco

    2015-06-01

    Chondroblastoma-like osteosarcomas are extremely rare malignancies having varying clinical, radiological and histological features. Their rarity causes challenges in both diagnosis and clinical management. They are often misdiagnosed as benign lesions. Their accurate diagnosis is important because they require adequate treatment. Misdiagnosed lesions or undertreatment may result in recurrences. We report a case of chondroblastoma-like osteosarcoma arising in the left first metatarsal bone with tarsometatarsal joint involvement in a 10-year-old boy for whom surgery with an original technique was planned after a multidisciplinary diagnostic review. PMID:25492634

  19. Granulocytic sarcoma of the breast in acute myeloid leukemia: Two case reports

    PubMed Central

    FU, JIANFEI; LUO, JIANSHENG

    2014-01-01

    Granulocytic sarcoma (GS) of the breast is extremely rare in patients with acute myeloid leukemia (AML) and therefore, is often misdiagnosed as lymphoma or other benign tumors. The current report presents two cases of GS of the breast, of which, one was considered to be a fibroma, as observed by fine-needle aspiration, and the other was misdiagnosed as lymphoma by frozen section. Previous literature that described the clinical and pathological characteristics, treatments and prognosis of GS of the breast in AML were reviewed. In addition to the treatment of mastectomy with/without radiotherapy, lumpectomy may also be received as a good treatment plan. PMID:24348837

  20. Estimates of variance components for genetic correlations among swine estrus traits.

    PubMed

    Knauer, M T; Cassady, J P; Newcom, D W; See, M T

    2010-09-01

    Variance components and genetic correlations were estimated among estrus, puberty, growth, and composition traits in Landrace-Large White gilts (n = 1,225; Genetic Improvement Services, Newton Grove, NC) from 59 sires and 330 dams. Four groups of gilts entered the North Carolina Swine Evaluation Station in Clayton at an average age of 162 d and were checked daily for estrus. Once 70% of gilts had reached puberty, recording of estrus symptoms occurred every 12 h for 30 d, using fence-line boar contact. Subjective estrus traits were maximum strength of standing reflex with or without a boar present, total strength of standing reflex with or without a boar present, and strength of vulva reddening and swelling. Objective estrus traits consisted of vulva redness, vulva width, length of estrus in consecutive days based on 12-h observations, and age at puberty (AGEPUB). Growth and composition traits included puberty weight, days to 114 kg (DYS), 10th-rib backfat, and 10th-rib LM area at 114 kg (BF, LMA) and puberty. Variance components were estimated using AIREMLF90 with an animal model. All models included gilt development diet class and breed composition as fixed effects, entry age as a covariate (except DYS, BF, and LMA), a random common litter effect, and a random animal genetic effect. Heritability estimates for length of estrus, maximum strength of the standing reflex with a boar, total strength of the standing reflex with a boar, maximum strength of the standing reflex without a boar, total strength of the standing reflex without a boar, vulva redness, strength of vulva reddening and swelling, and vulva width were 0.21, 0.13, 0.26, 0.42, 0.42, 0.26, 0.45, and 0.58, respectively. Heritability estimates for AGEPUB, puberty weight, 10th-rib backfat at puberty, 10th-rib LM area at puberty, DYS, BF, and LMA were 0.29, 0.39, 0.41, 0.38, 0.24, 0.47, and 0.39, respectfully. Common litter effect estimates ranged from 0.01 to 0.09. The estimated genetic correlation between length of estrus and maximum strength of standing reflex with a boar was 0.99. Genetic correlations between AGEPUB and length of estrus, maximum strength of standing reflex with a boar, and vulva redness were -0.23, -0.32, and 0.20, respectively. Length of estrus had positive genetic associations with DYS and BF (0.30 and 0.29, respectively). It was concluded that past selection for lean BW gain may have weakened the strength of the standing reflex and that sufficient genetic variation exists to make selection for improved swine estrus traits effective. PMID:20525928

  1. Dehydration, Heat Stroke, or Hyponatremia? The Recognition, Treatment, and Prevention of Hyponatremia Caused by High Exercise Outdoor Activities.

    ERIC Educational Resources Information Center

    Cochran, Brent

    Hyponatremia (severe sodium depletion) has symptoms similar to heat exhaustion and heat stroke and can easily be misdiagnosed. The number of wilderness users and extreme adventure activities has increased in recent years, and more cases are being diagnosed. Given that a 1993 study found that 1 in 10 cases of heat-related illnesses were

  2. Chlorine Dioxide Induced Multiple Chemical Sensitivity: MMPI Validity Problems.

    ERIC Educational Resources Information Center

    Tentoni, Stuart C.

    This paper discusses Minnesota Multiphasic Personality Inventory (MMPI) data obtained from individuals exposed to chlorine dioxide in the workplace who developed Multiple Chemical Sensitivity Syndrome. The paper explores current research on chlorine dioxide exposed persons who were misdiagnosed on the basis of MMPI interpretations. Difficulties…

  3. Identifying Intermittent Central Suppression to Improve Reading.

    ERIC Educational Resources Information Center

    Whiteaker, Janet; Zolg, Carolyn

    2001-01-01

    Describes Intermittent Central Suppression (ICS), a treatable eye malfunction that can make reading difficult. Reports that some students with ICS are not diagnosed through standard vision acuity tests and are misdiagnosed as learning disabled. Presents a study that found that students who were treated for ICS stayed in school longer than students…

  4. Neosporosis in dogs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Neospora caninum is a protozoan parasite of animals. Until 1988, it was misdiagnosed as Toxoplasma gondii. Since its first recognition in 1984 and the description of a new genus and species Neospora caninum in 1988, neosporosis has emerged as a serious disease of dogs and cattle worldwide. Additiona...

  5. Dissociative Disorders in Children: Behavioral Profiles and Problems.

    ERIC Educational Resources Information Center

    Putnam, Frank W.

    1993-01-01

    Clinical research has established a connection between childhood trauma and the development of dissociative disorders in adults. Pathological dissociation produces a range of symptoms and behaviors such as amnesias, rapid shifts in mood and behavior, and auditory and visual hallucinations. Many of these symptoms are misdiagnosed as attention,

  6. Imaging characteristics of disseminated Geosmithia argillacea causing severe diskospondylitis and meningoencephalomyelitis in a dog.

    PubMed

    Kawalilak, Lukas T; Chen, Annie V; Roberts, Greg R

    2015-11-01

    A 4-year-old male castrated Labrador Retriever presented for severe spinal pain. Radiographs and magnetic resonance imaging showed evidence of diskospondylitis and meningoencephalomyelitis. Blood culture revealed a Geosmithia argillacea fungal infection after DNA sequencing, initially misdiagnosed as Penicillium species. Geosmithia argillacea should be considered as a differential for disseminated fungal diskospondylitis. PMID:26576269

  7. Zika Virus Infection Acquired During Brief Travel to Indonesia

    PubMed Central

    Kwong, Jason C.; Druce, Julian D.; Leder, Karin

    2013-01-01

    Zika virus infection closely resembles dengue fever. It is possible that many cases are misdiagnosed or missed. We report a case of Zika virus infection in an Australian traveler who returned from Indonesia with fever and rash. Further case identification is required to determine the evolving epidemiology of this disease. PMID:23878182

  8. Dehydration, Heat Stroke, or Hyponatremia? The Recognition, Treatment, and Prevention of Hyponatremia Caused by High Exercise Outdoor Activities.

    ERIC Educational Resources Information Center

    Cochran, Brent

    Hyponatremia (severe sodium depletion) has symptoms similar to heat exhaustion and heat stroke and can easily be misdiagnosed. The number of wilderness users and extreme adventure activities has increased in recent years, and more cases are being diagnosed. Given that a 1993 study found that 1 in 10 cases of heat-related illnesses were…

  9. Rickettsia and Bartonella Species in Fleas from Reunion Island

    PubMed Central

    Dieme, Constentin; Parola, Philippe; Guernier, Vanina; Lagadec, Erwan; Le Minter, Gildas; Balleydier, Elsa; Pagès, Frederic; Dellagi, Koussay; Tortosa, Pablo; Raoult, Didier; Socolovschi, Cristina

    2015-01-01

    Rickettsia felis, Rickettsia typhi, and Bartonella DNA was detected by molecular tools in 12% of Rattus rattus fleas (Xenopsylla species) collected from Reunion Island. One-third of the infested commensal rodents captured during 1 year carried at least one infected flea. As clinical signs of these zoonoses are non-specific, they are often misdiagnosed. PMID:25646263

  10. Neosporosis.

    PubMed

    Dubey, J P; Lindsay, D S

    1993-12-01

    Neospora caninum is a recently recognized protozoan parasite of animals, which, until 1988, was misdiagnosed as Toxoplasma gondii. Neospora caninum or Neospora-like parasites, here discussed by J.P. Dubey and David Lindsay, cause paralysis and death in dogs and neonatal mortality and abortion in cattle, sheep, goats and horses. PMID:15463690

  11. Male Anorexia Nervosa: A New Focus.

    ERIC Educational Resources Information Center

    Crosscope-Happel, Cindy; Hutchins, David E.; Getz, Hildy G.; Hayes, Gerald L.

    2000-01-01

    Although anorexia nervosa affects over one million males yearly, it is often misdiagnosed or overlooked by mental health and medical practitioners. This article brings the problem to the forefront and outlines features that are unique to these males. Greater recognition of the disorder can lead to more accurate diagnoses and, subsequently, better…

  12. Systemic lupus erythematosus and antiphospholipid syndrome related retinal vasculitis mimicking ocular cysticercosis: a case report.

    PubMed

    Wu, Chan; Dong, Fang-tian; Chen, You-xin; Wang, Qian; Dai, Rong-ping; Zhang, Hua

    2015-03-01

    Making accurate and timely diagnosis is often challenging when patients with a systemic disease first present with ocular manifestations. The possibility that vasculitis associated with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) can be misdiagnosed as cysticercosis has not been discussed in the literatures. PMID:25837363

  13. Primary Cardiac Lymphoma: Helical CT Findings and Radiopathologic Correlation

    SciTech Connect

    Marco de Lucas, Enrique Pagola, Miguel Angel; Fernandez, Fidel; Lastra, Pedro; Delgado, M. Luisa Ruiz; Sadaba, Pablo; Pinto, Jesus; Ballesteros, Ma Angeles; Ortiz, Antonio

    2004-03-15

    Primary tumors of the heart are extremely rare.Clinical manifestations are nondiagnostic and the patients are often misdiagnosed. Magnetic resonance imaging and echocardiography are standard in this diagnostic workup. We report a case of a man with acromegaly, dysphagia, chest pain and weight loss. An invasive cardiac mass was diagnosed by helical-CT. Autopsy demonstrated a B-cell aggressive lymphoma.

  14. Silent Suffering: Children with Selective Mutism

    ERIC Educational Resources Information Center

    Camposano, Lisa

    2011-01-01

    Despite increasing awareness, the childhood disorder of selective mutism is under-researched and commonly misdiagnosed. The purpose of this article is to highlight current issues related to this disorder as well as describe various treatment approaches including behavioral, cognitive-behavioral, psychodynamic, family, and pharmacological…

  15. Sentence Repetition as a Measure of Morphosyntax in Monolingual and Bilingual Children

    ERIC Educational Resources Information Center

    Komeili, Mariam; Marshall, Chloe R.

    2013-01-01

    Bilingual children are frequently misdiagnosed as having Specific Language Impairment (SLI). Misdiagnosis may be minimized by tests with high degrees of sensitivity and specificity. The current study used a new test, the School-Age Sentence Imitation Test-English 32 (SASIT-E32), to investigate sentence repetition in monolingual and bilingual…

  16. Challenging diagnosis of peripillous sheaths.

    PubMed

    Gnarra, Maria; Saraceni, Pierluigi; Rossi, Alfredo; Murabit, Amera; Caradonna, Emanuela; Fania, Luca; Feliciani, Claudio

    2014-01-01

    Peripillous sheaths, or hair casts, are asymptomatic, white, cylindrical concretions that encircle the hair without adhering to it. They are infrequently documented in the literature, are often misdiagnosed, and generate avoidable apprehension and expense for parents and caregivers. Dermoscopy is the standard for a rapid, noninvasive, cost-effective diagnosis. We describe a case of peripillous sheaths presenting in a boy. PMID:24846654

  17. Flow accelerated corrosion

    SciTech Connect

    Port, R.D.

    1998-12-31

    Flow accelerated corrosion has recently attracted attention in association with heat recovery steam generators. Apparently, the phenomenon is more widespread than is realized and has been misdiagnosed as simple erosion. This paper addresses the principal environmental conditions that have been linked to flow accelerated corrosion and it illustrates the phenomenon with case histories.

  18. Duplicated Origin of the Left Vertebral Artery: A Case Report and Embryological Review

    PubMed Central

    Jung, Seunguk; Bae, Yun Jung; Choi, Byung Se; Kim, Jae Hyoung

    2016-01-01

    The duplicated origin of vertebral artery (VA) is a very rare condition. It could be easily misdiagnosed as an arterial dissection on selective catheter angiography, especially in a patient with acute cerebellar infarction of unknown etiology. We report a patient with an acute cerebellar infarction and duplicated origin of the left VA, which was found during the selective catheter angiography. PMID:26958414

  19. Hypothesis-Driven Story Building: Counteracting Human Cognitive Biases to Improve Medical Diagnosis Support

    ERIC Educational Resources Information Center

    Zhu, Shizhuo

    2010-01-01

    Clinical decision-making is challenging mainly because of two factors: (1) patient conditions are often complicated with partial and changing information; (2) people have cognitive biases in their decision-making and information-seeking. Consequentially, misdiagnoses and ineffective use of resources may happen. To better support clinical…

  20. Imaging Misdiagnosis Analysis of a Rare Case of Renal Subcapsular Hematoma Located in the Renal Hilum and Collecting Area☆

    PubMed Central

    Li, Biqiang; Huang, Xianlong; Wang, Xiaoming; Wang, Xinyu; Yang, Jian

    2014-01-01

    We report a rare case of renal subcapsular hematoma, which was located in the renal hilum and collecting area. Preoperative ultrasonography, retrograde urethrography, and computed tomographic examinations misdiagnosed the patient with simple hydronephrosis, without finding a lesion causing the hydronephrosis. We retrospectively summarized the imaging features and analyzed the reasons leading to the misdiagnosis.

  1. Diagnosis, Dogmatism, and Rationality.

    ERIC Educational Resources Information Center

    Rabinowitz, Jonathan; Efron, Noah J.

    1997-01-01

    Presents findings suggesting that misdiagnoses frequently stem from flaws in human information processing, particularly in collecting and using information. Claims that improved diagnostic tools will not remedy the problem. Drawing on the work of Karl Popper and Robin Collingwood, proposes operational principles to ensure a rational diagnostic…

  2. A case of peduncular hallucinosis presenting as a primary psychiatric disorder.

    PubMed

    Dogan, Vasfiye Burcu; Dirican, Ayten; Koksal, Ayhan; Baybas, Sevim

    2013-10-01

    Peduncular hallucinosis usually occurs due to vascular or infectious midbrain lesions or brain stem compression by tumors. We present a peduncular hallucinosis case in a 63-year-old female with brain stem infarction, which can easily be misdiagnosed as a psychiatric disorder. PMID:24339609

  3. Tourette Syndrome.

    ERIC Educational Resources Information Center

    Look, Kathy

    Tourette Syndrome has a history of being misdiagnosed or undiagnosed due to its unusual and complex symptoms. This paper describes: the symptoms of Tourette Syndrome; its etiology; age of onset; therapeutic methods, such as drug therapy, psychotherapy, diet control, and hypnosis; educational implications; and employment prospects. Several…

  4. Sanctuary or Sanction?

    ERIC Educational Resources Information Center

    Newsom, John

    2001-01-01

    A Harvard study suggests that minority students are often misdiagnosed as mentally retarded or behaviorally disabled; African-Americans are overrepresented in special-education classes and trail whites in achievement. Students are frequently placed in separate classes or schools. Predictable classroom routines can help kids with behavior problems.…

  5. Monogenic Diabetes

    MedlinePlus

    ... gene. In contrast, the most common types of diabetes—type 1 and type 2—are caused by multiple genes ( ... some children with monogenic diabetes are misdiagnosed with type 1 diabetes and are given insulin. When correctly diagnosed, some ...

  6. High-Performing Families: Causes, Consequences, and Clinical Solutions. The Family Psychology and Counseling Series.

    ERIC Educational Resources Information Center

    Robinson, Bryan E., Ed.; Chase, Nancy D., Ed.

    This book explores the dilemma of the increasing obsession with work and the resulting imbalances between career and family life. Through theoretical frameworks and case examples it discusses the negative consequences of the societal phenomena of over-work and over-dedication to careers, which have been misdiagnosed or ignored by mental health…

  7. A Preliminary Report on the English Phonology of Typically Developing English-Mandarin Bilingual Preschool Singaporean Children

    ERIC Educational Resources Information Center

    En, Lydea Gn Wei; Brebner, Chris; McCormack, Paul

    2014-01-01

    Background: There are no published data on typical phonological development for Singaporean children. There is therefore the risk that children's speech in Singapore may be misdiagnosed or that clinicians may set goals erroneously. Aims: This paper reports a preliminary study on the English phonology of typically developing 4;0-4;5-year-old…

  8. Neuroleptic malignant syndrome and subsequent clozapine-withdrawal effects in a patient with refractory schizophrenia

    PubMed Central

    Cheng, Minfeng; Gu, Huaying; Zheng, Liangrong; Wang, Houliang; Zhong, Zhiyong; Wen, Shenglin

    2016-01-01

    Here, we report a female patient developing neuroleptic malignant syndrome following the use of a combination of clozapine and haloperidol. Subsequently, the patient presented withdrawal effects after an abrupt discontinuation of clozapine. Psychiatrists not aware of possible clozapine-withdrawal effects may misdiagnose as a part of the primary mental illness or as the initial symptoms worsening, if unrecognized. PMID:27099499

  9. Zika virus infection acquired during brief travel to Indonesia.

    PubMed

    Kwong, Jason C; Druce, Julian D; Leder, Karin

    2013-09-01

    Zika virus infection closely resembles dengue fever. It is possible that many cases are misdiagnosed or missed. We report a case of Zika virus infection in an Australian traveler who returned from Indonesia with fever and rash. Further case identification is required to determine the evolving epidemiology of this disease. PMID:23878182

  10. Abdominal emergencies in the geriatric patient

    PubMed Central

    2014-01-01

    Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities. PMID:25635203

  11. Hyperkeratotic acral melanoma mimicking a common wart.

    PubMed

    Vindigni, Vincenzo; Scarpa, Carlotta; Bassetto, Franco

    2015-04-01

    Acral melanoma is a great pretender; anything but i nfrequently, it adopts clinical faces, simulating skin conditions that make the healthcare provider diagnose it as a benign disease of the palms, soles, and ungual regions. We present a case of a hyperkeratotic acral melanoma that has been misdiagnosed and that has led to an amputation of the thumb. PMID:25973355

  12. Gliomatosis cerebri presenting as idiopathic intracranial hypertension in a child.

    PubMed

    Zunz, Eran; Ben Sira, Liat; Constantini, Shlomi; Fattal-Valevski, Aviva; Yalon, Michal; Roth, Jonathan; Cagnano, Emanuela; Kesler, Anat

    2011-12-01

    We present a rare case of a diffuse anaplastic astrocytoma (gliomatosis configuration) in a child, which was misdiagnosed as pseudotumor cerebri following initially normal CT of the brain and elevated opening pressure on lumbar puncture with normal cerebrospinal composition. PMID:21566531

  13. A case of adolescent giant parathyroid adenoma presenting multiple osteolytic fractures and postoperative hungry bone syndrome

    PubMed Central

    Ebina, Kosuke; Miyoshi, Yuji; Izumi, Shinji; Hashimoto, Jun; Naka, Norifumi; Tsukamoto, Yasunori; Kashii, Masafumi; Kaito, Takashi; Yoshikawa, Hideki

    2015-01-01

    Key Clinical Message Primary hyperparathyroidism (PHPT) and postoperative hungry bone syndrome are very rare conditions in adolescents, and may be frequently misdiagnosed as a metastatic bone tumor. However, delay in diagnosis may lead to a fatal preoperative hypercalcemia and postoperative hypocalcemia. PHPT is a differential diagnosis of adolescent hypercalcemia and osteolytic fractures. PMID:26509019

  14. Neosporosis in animals-the last five years

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Neospora caninum is a protozoan parasite of animals. Until 1988, it was misdiagnosed as Toxoplasma gondii. Since its first recognition in 1984 in dogs and the description of a new genus and species Neospora caninum in 1988, neosporosis has emerged as a serious disease of cattle and dogs worldwide. ...

  15. Childhood Vestibular Disorders: A Tutorial

    ERIC Educational Resources Information Center

    Mehta, Zarin; Stakiw, Daria B.

    2004-01-01

    There is a growing body of evidence that childhood disorders affecting the vestibular system, although rare, do exist. Describing symptoms associated with the vestibular mechanism for children may be difficult, resulting in misdiagnosing or under-diagnosing these conditions. The pathophysiology, symptoms, and management options of the more common…

  16. Two masquerade presentations of retinoblastoma.

    PubMed

    Lembo, Andrea; Pichi, Francesco; Santangelo, Elisabetta; Carrai, Paola; Hadjistilianou, Theodora; Serafino, Massimiliano; Nucci, Paolo

    2016-04-01

    Masquerade syndromes are disorders occurring with intraocular inflammation misdiagnosed as uveitis. The underlying causes may be benign or malignant conditions, and one of the most important diagnoses to take into consideration in children is retinoblastoma. We present two cases with uncertain early misdiagnosis whose definite diagnosis eventually was retinoblastoma. PMID:26449229

  17. Pars Plana Vitrectomy and Evisceration Resulting in Death Due to Misdiagnosis of Retinoblastoma in Children

    PubMed Central

    Shen, Tao; Liu, Rongjiao; Lin, Jing; Huang, Huiqun; Li, Xiuling; Yan, Jianhua

    2015-01-01

    Retinoblastoma is a curable intraocular malignancy in children. However, in clinical practice, retinoblastoma can sometimes be misdiagnosed and mismanaged, leading to extraocular extension and even death. In this report, a series of 3 cases are related that emphasize the conditions and consequences resulting from misdiagnosis and mismanagement of retinoblastoma. The clinical features, imaging findings, histopatholigical examination, and management in 3 case reports of children with misdiagnosed retinoblastoma are presented. Two of the cases received pars plana vitrectomy after being misdiagnosed with Coats disease or ocular blunt trauma, whereas the third case received evisceration after being misdiagnosed with suppurative endophthalmitis. When the diagnosis of retinoblastoma had been confirmed after a second surgery was performed in our hospital, only 2 of the cases received adjuvant orbital radiotherapy. All 3 cases died of systemic tumor metastases. Intraocular surgical procedures should be avoided in any equivocal case until the possibility of latent retinoblastoma is eliminated. We strongly recommend that early enucleation be executed as soon as possible followed by postoperative adjuvant therapy under conditions wherein an intraocular surgery was inadvertently performed in an eye with retinoblastoma. PMID:26266382

  18. The Alphabet Children: GT, ADHD, and More.

    ERIC Educational Resources Information Center

    Baum, Susan M.; Olenchak, F. Richard

    2002-01-01

    This article explores the problems that occur when gifted children are misdiagnosed with additional exceptionalities. This dilemma is illustrated through a case study of a gifted child diagnosed with attention deficit hyperactivity disorder. Guidelines are suggested for careful diagnosis and a diagnostic matrix for interpreting behavior is…

  19. Lyme Disease: Implications for Health Educators.

    ERIC Educational Resources Information Center

    Harbit, Maryanne Drake; Willis, Dawn

    1990-01-01

    Lyme disease may be one of the most commonly misdiagnosed diseases of this decade. Health educators should be knowledgeable about this new disease and be able to share with the public information about prevention, early signs and symptoms, and treatment of the disease (Author/IAH)

  20. Dissociative Disorders in Children: Behavioral Profiles and Problems.

    ERIC Educational Resources Information Center

    Putnam, Frank W.

    1993-01-01

    Clinical research has established a connection between childhood trauma and the development of dissociative disorders in adults. Pathological dissociation produces a range of symptoms and behaviors such as amnesias, rapid shifts in mood and behavior, and auditory and visual hallucinations. Many of these symptoms are misdiagnosed as attention,…

  1. POEMS Syndrome: A Rare Disease With A Challenging Diagnosis.

    PubMed

    Delgado Flores, Glorilee; Robles Cartagena, América; Robles Cartagena, Ivonne; Muñiz, Armando; Cabanillas, Fernando; Vicens, Rafael

    2015-01-01

    A complex conglomerate of symptoms, signs, and abnormalities are present with POEMS syndrome, making the diagnosis, management and follow-up a challenge. Recognizing the disease early on may be difficult. Many patients are initially misdiagnosed as having others disorders, for example: multiple myeloma. There is no standard treatment for patients diagnosed with POEMS syndrome. PMID:26742203

  2. Optimal Outcome in Individuals with a History of Autism

    ERIC Educational Resources Information Center

    Fein, Deborah; Barton, Marianne; Eigsti, Inge-Marie; Kelley, Elizabeth; Naigles, Letitia; Schultz, Robert T.; Stevens, Michael; Helt, Molly; Orinstein, Alyssa; Rosenthal, Michael; Troyb, Eva; Tyson, Katherine

    2013-01-01

    Background: Although autism spectrum disorders (ASDs) are generally considered lifelong disabilities, literature suggests that a minority of individuals with an ASD will lose the diagnosis. However, the existence of this phenomenon, as well as its frequency and interpretation, is still controversial: were they misdiagnosed initially, is this a…

  3. Childhood Vestibular Disorders: A Tutorial

    ERIC Educational Resources Information Center

    Mehta, Zarin; Stakiw, Daria B.

    2004-01-01

    There is a growing body of evidence that childhood disorders affecting the vestibular system, although rare, do exist. Describing symptoms associated with the vestibular mechanism for children may be difficult, resulting in misdiagnosing or under-diagnosing these conditions. The pathophysiology, symptoms, and management options of the more common

  4. Rickettsia and Bartonella species in fleas from Reunion Island.

    PubMed

    Dieme, Constentin; Parola, Philippe; Guernier, Vanina; Lagadec, Erwan; Le Minter, Gildas; Balleydier, Elsa; Pagès, Frederic; Dellagi, Koussay; Tortosa, Pablo; Raoult, Didier; Socolovschi, Cristina

    2015-03-01

    Rickettsia felis, Rickettsia typhi, and Bartonella DNA was detected by molecular tools in 12% of Rattus rattus fleas (Xenopsylla species) collected from Reunion Island. One-third of the infested commensal rodents captured during 1 year carried at least one infected flea. As clinical signs of these zoonoses are non-specific, they are often misdiagnosed. PMID:25646263

  5. Facial fistula

    PubMed Central

    Alasseri, Nasser A.; Assari, Ahmad S.

    2015-01-01

    Facial cutaneous fistula is a complication of odontogenic infection that is often misdiagnosed with dermatological infection, and hence, mistreated. We report a case of facial fistula that developed 8 years following a dental extraction, presenting its clinical appearance, radiographical findings, and treatment approach. PMID:25828289

  6. A misdiagnosis of clonorchiasis as gallstone, leading to an unnecessary cholecystectomy: a case report.

    PubMed

    Sun, Qingsong; Liu, Xiaolei; Hao, Yuhua; Li, YuXiang; Bai, Xue; Wang, Feng; Liu, Mingyuan

    2014-11-01

    This case report describes an unusual presentation of Clonorchissinensis infection. In this rare case, a clonorchiasis infection that had been latent for decades was misdiagnosed as acute calculous cholecystitis.Exploratory surgery and a cholecystectomy were performed. Therefore,in the course of diagnosis of hepatic and gall diseases, we cannot neglect parasite infections such as clonorchiasis. PMID:24881515

  7. Development of an Online Resource to Support General Education Elementary School Teachers in a Response to Intervention Model for Struggling Readers

    ERIC Educational Resources Information Center

    Lopez, Jennifer L.

    2010-01-01

    The number of students who are being identified as having a learning disability is rising at an alarming rate, creating concerns regarding misdiagnoses and overrepresentation of minority groups in special education. Response to Intervention (RtI) has emerged as a scientifically validated approach to delivering quality interventions early in a…

  8. Full Body Gait Analysis May Improve Diagnostic Discrimination Between Hereditary Spastic Paraplegia and Spastic Diplegia: A Preliminary Study

    ERIC Educational Resources Information Center

    Bonnefoy-Mazure, A.; Turcot, K.; Kaelin, A.; De Coulon, G.; Armand, S.

    2013-01-01

    Hereditary spastic paraplegia (HSP) and spastic diplegia (SD) patients share a strong clinical resemblance. Thus, HSP patients are frequently misdiagnosed with a mild form of SD. Clinical gait analysis (CGA) has been highlighted as a possible tool to support the differential diagnosis of HSP and SD. Previous analysis has focused on the lower-body…

  9. Living with the Active Alert Child: Groundbreaking Strategies for Parents. Third Edition.

    ERIC Educational Resources Information Center

    Budd, Linda S.

    Bright, controlling, fearful, and highly energetic, active alert children are frequently misdiagnosed as hyperactive or learning disabled. This book offers guidance for the special challenge of parenting the active alert infant, child, and adolescent. Part 1 of the book profiles the active alert child and examines 11 traits that characterize

  10. Urinary incontinence.

    PubMed Central

    Resnick, N M

    1987-01-01

    Incontinence has about a 15 percent prevalence among elderly women. Some of the factors associated with incontinence are psychosocial implications of stigmatization, the decreased quality of life, and the economic considerations of nursing home costs. There are numerous, often misdiagnosed, reversible causes of incontinence, and many of the problems associated with aging may be alleviated if incontinence is treated symptomatically and controlled. PMID:3120223

  11. Multiple Brown Tumors Caused by a Parathyroid Adenoma Mimicking Metastatic Bone Disease from Giant Cell Tumor

    PubMed Central

    Phulsunga, Rohit Kumar; Parghane, Rahul Vithalrao; Kanojia, Rajendra K.; Gochhait, Debasis; Sood, Ashwani; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2016-01-01

    Brown tumor affects multiple bones in the body with variable clinical symptoms, which may be misdiagnosed as multiple bone metastases or primary bone tumor. In the present case report, we report the usefulness of 99mTc-MDP bone scan and 99mTc-MIBI whole body scan in differentiating brown tumor of hyperparathyroidism from giant cell tumor. PMID:26912981

  12. High-Performing Families: Causes, Consequences, and Clinical Solutions. The Family Psychology and Counseling Series.

    ERIC Educational Resources Information Center

    Robinson, Bryan E., Ed.; Chase, Nancy D., Ed.

    This book explores the dilemma of the increasing obsession with work and the resulting imbalances between career and family life. Through theoretical frameworks and case examples it discusses the negative consequences of the societal phenomena of over-work and over-dedication to careers, which have been misdiagnosed or ignored by mental health

  13. Diagnosis or Misdiagnosis

    ERIC Educational Resources Information Center

    Webb, James T.; Goerss, Jean; Amend, Edward R.; Webb, Nadia E.; Beljan, Paul; Olenchak, F. Richard

    2006-01-01

    How frequently are gifted children misdiagnosed? Frankly, there are no research data, though the authors know it occurs, and perhaps frequently. How do individuals draw this conclusion? Because the authors have tested children whose parents have come to them for a second (or third) opinion, and in their clinical experience it appears that…

  14. The radiological appearances of telangiectatic osteosarcoma. A study of 14 cases.

    PubMed

    Vanel, D; Tcheng, S; Contesso, G; Zafrani, B; Kalifa, C; Dubousset, J; Kron, P

    1987-01-01

    Fourteen telangiectatic osteosarcomas are reported. They are rare, clinically and radiologically aggressive lesions, involving mainly the femurs of young patients, often misdiagnosed as aneurysmal bone cysts. An explanation for a characteristic early radiological appearance consisting of regular parallel striations of the shaft is suggested. PMID:3473690

  15. Male Anorexia Nervosa: A New Focus.

    ERIC Educational Resources Information Center

    Crosscope-Happel, Cindy; Hutchins, David E.; Getz, Hildy G.; Hayes, Gerald L.

    2000-01-01

    Although anorexia nervosa affects over one million males yearly, it is often misdiagnosed or overlooked by mental health and medical practitioners. This article brings the problem to the forefront and outlines features that are unique to these males. Greater recognition of the disorder can lead to more accurate diagnoses and, subsequently, better

  16. Identifying Hearing Loss in Young Children: Technology Replaces the Bell

    ERIC Educational Resources Information Center

    Eiserman, William; Shisler, Lenore

    2010-01-01

    Hearing loss can too easily be misdiagnosed or overlooked by providers serving young children. Parents and professionals may observe a language delay--an "invisible" condition--while failing to identify the underlying cause. Otoacoustic emissions (OAE) hearing screening technology, used extensively with newborns, is becoming an essential tool,…

  17. Hyperkeratotic Acral Melanoma Mimicking a Common Wart

    PubMed Central

    Vindigni, Vincenzo; Bassetto, Franco

    2015-01-01

    Summary: Acral melanoma is a great pretender; anything but i nfrequently, it adopts clinical faces, simulating skin conditions that make the healthcare provider diagnose it as a benign disease of the palms, soles, and ungual regions. We present a case of a hyperkeratotic acral melanoma that has been misdiagnosed and that has led to an amputation of the thumb. PMID:25973355

  18. Metastatic hepatic actinomycosis masquerading as distant metastases of ovarian cancer.

    PubMed

    Kim, Young Sun; Lee, Bo Yon; Jung, Min Hyung

    2012-03-01

    Actinomycosis is a chronic disease characterized by abscess, tissue fibrosis and draining sinuses. Pelvic actinomycosis in women most commonly occurs during ascending infections, which are usually associated with intrauterine devices; however, secondary hepatic actinomycosis, while rare, can also occur. We describe a patient with an unusual case of metastatic hepatic actinomycosis misdiagnosed as distant metastases of ovarian cancer. PMID:22381113

  19. Living with the Active Alert Child: Groundbreaking Strategies for Parents. Third Edition.

    ERIC Educational Resources Information Center

    Budd, Linda S.

    Bright, controlling, fearful, and highly energetic, active alert children are frequently misdiagnosed as hyperactive or learning disabled. This book offers guidance for the special challenge of parenting the active alert infant, child, and adolescent. Part 1 of the book profiles the active alert child and examines 11 traits that characterize…

  20. Anisakiasis and gastroallergic reactions associated with Anisakis pegreffii infection, Italy.

    PubMed

    Mattiucci, Simonetta; Fazii, Paolo; De Rosa, Alba; Paoletti, Michela; Megna, Angelo Salomone; Glielmo, Antonio; De Angelis, Maurizio; Costa, Antonella; Meucci, Costantino; Calvaruso, Vito; Sorrentini, Italo; Palma, Giuseppe; Bruschi, Fabrizio; Nascetti, Giuseppe

    2013-03-01

    Human cases of gastric anisakiasis caused by the zoonotic parasite Anisakis pegreffii are increasing in Italy. The disease is caused by ingestion of larval nematodes in lightly cooked or raw seafood. Because symptoms are vague and serodiagnosis is difficult, the disease is often misdiagnosed and cases are understimated. PMID:23621984

  1. Anisakiasis and Gastroallergic Reactions Associated with Anisakis pegreffii Infection, Italy

    PubMed Central

    Fazii, Paolo; De Rosa, Alba; Paoletti, Michela; Megna, Angelo Salomone; Glielmo, Antonio; De Angelis, Maurizio; Costa, Antonella; Meucci, Costantino; Calvaruso, Vito; Sorrentini, Italo; Palma, Giuseppe; Bruschi, Fabrizio; Nascetti, Giuseppe

    2013-01-01

    Human cases of gastric anisakiasis caused by the zoonotic parasite Anisakis pegreffii are increasing in Italy. The disease is caused by ingestion of larval nematodes in lightly cooked or raw seafood. Because symptoms are vague and serodiagnosis is difficult, the disease is often misdiagnosed and cases are understimated. PMID:23621984

  2. First Detection of Human Dirofilariasis in South Africa

    PubMed Central

    Moodley, Krishnee; Govind, Chetna N.; Peer, Abdool K.C.; van der Westhuizen, Marissa; Parbhoo, Dharmesh; Sun, Lisa Ming; du Plessis, Desiree C.; Frean, John A.

    2015-01-01

    Humans are occasionally inadvertently infected with dirofilariae, the zoonotic nematodes. We report two cases of human dirofilariasis in South Africa, an area apparently non-endemic for this infection. Dirofilariasis is frequently misdiagnosed, so increased awareness of this entity in areas that are non-endemic is essential for prevention of inappropriate investigations and invasive therapy. PMID:25874068

  3. Empirically Informed Attention-Deficit/Hyperactivity Disorder Evaluation with College Students

    ERIC Educational Resources Information Center

    Reilley, Sean P.

    2005-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is both an underdiagnosed and a misdiagnosed problem on college campuses, leading to pronounced academic and psychosocial difficulties. Counselors encounter diagnostic criteria that are child oriented, long lists of differential diagnoses, high rates of coexisting disorders, and no definitive tests

  4. Mis-Diagnosis and Dual Diagnosis of Gifted Children: Gifted and LD, ADHD, OCD, Oppositional Defiant Disorder.

    ERIC Educational Resources Information Center

    Webb, James T.

    Many gifted and talented children are often misdiagnosed by psychologists and other health professionals as having Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Disorder (OD), Obsessive Compulsive Disorder (OCD), or another of the mood disorders. The misdiagnosis can stem from mistaken assumptions being made about the social and…

  5. Benign pelvic masses masquerading as adnexal cancer during pregnancy on ultrasound: A retrospective study of 5 years

    PubMed Central

    XIE, MENG; ZHANG, XUYIN; WANG, WENPING; HUA, KEQIN

    2015-01-01

    This study was conducted to investigate the sonographic characteristics of benign adnexal masses misdiagnosed as malignancy, and determine whether sonographic findings may help distinguish these lesions from malignant tumors during pregnancy at a single center. We herein present our experience with pregnant women with benign adnexal masses misdiagnosed as malignancy by ultrasound and operated on during pregnancy or after delivery. A total of 4 cases of benign pelvic masses were misdiagnosed as adnexal cancer over a 5-year period, including an ovarian theca cell tumor with luteinization, an obsolete ectopic pregnancy of fallopian tube, an ovarian mature teratoma with abundant nervous tissue and a uterine myoma with degeneration. The masses were characterized by abundant blood flow and heterogeneous echo on ultrasound. In conclusion, adnexal masses identified during pregnancy exhibiting abundant blood flow and heterogeneous echo may not represent malignancy, even in the presence of increased carbohydrate antigen 125 levels. In certain cases, benign adnexal masses may be initially misdiagnosed as malignant during pregnancy. PMID:26807254

  6. CARBON MONOXIDE POISONING--A PUBLIC HEALTH PERSPECTIVE.

    EPA Science Inventory

    Carbon monoxide (CO) may be the cause of more than one-half of the fatal poisonings reported in many countries: fatal cases also are grossly under-reported or mis-diagnosed by medical professionals. Therefore, the precise number of individuals who have suffered from CO intoxicat...

  7. Lipedema, a frequently unrecognized problem.

    PubMed

    Fonder, Margaret A; Loveless, James W; Lazarus, Gerald S

    2007-08-01

    Lipedema is characterized by symmetric lower extremity enlargement secondary to the deposition of fat. Lipedema is not rare, but it is commonly misdiagnosed as lymphedema. We describe a 20-year-old woman with massive lower extremity enlargement that did not respond to compression therapy. Magnetic resonance imaging of the lower extremities helped to confirm the diagnosis. PMID:17637360

  8. Amatoxin-containing mushroom (Lepiota brunneoincarnata) familial poisoning.

    PubMed

    Varvenne, David; Retornaz, Karine; Metge, Prune; De Haro, Luc; Minodier, Philippe

    2015-04-01

    Serious to fatal toxicity may occur with amanitin-containing mushrooms ingestions. A Lepiota brunneoincarnata familial poisoning with hepatic toxicity is reported. In such poisonings, acute gastroenteritis may be firstly misdiagnosed leading to delay in preventing liver dysfunction by silibinin or penicillin G. Mushroom picking finally requires experience and caution. PMID:25831030

  9. Lacrimal canaliculitis

    PubMed Central

    Zaveri, Jill; Cohen, Adam J.

    2013-01-01

    Canaliculitis is an uncommon, often misdiagnosed diagnosis because canaliculitis can mimic many other common ocular conditions. Canaliculitis should be appropriately diagnosed and treated to avoid recurrent inflammation and possible obstruction of the upper portion of the lacrimal system. This review will serve as a concise resource to aid in diagnosis and provide updated management options. PMID:24526851

  10. Imaging characteristics of disseminated Geosmithia argillacea causing severe diskospondylitis and meningoencephalomyelitis in a dog

    PubMed Central

    Kawalilak, Lukas T; Chen, Annie V; Roberts, Greg R

    2015-01-01

    Key Clinical Message A 4-year-old male castrated Labrador Retriever presented for severe spinal pain. Radiographs and magnetic resonance imaging showed evidence of diskospondylitis and meningoencephalomyelitis. Blood culture revealed a Geosmithia argillacea fungal infection after DNA sequencing, initially misdiagnosed as Penicillium species. Geosmithia argillacea should be considered as a differential for disseminated fungal diskospondylitis. PMID:26576269

  11. Sentence Repetition as a Measure of Morphosyntax in Monolingual and Bilingual Children

    ERIC Educational Resources Information Center

    Komeili, Mariam; Marshall, Chloe R.

    2013-01-01

    Bilingual children are frequently misdiagnosed as having Specific Language Impairment (SLI). Misdiagnosis may be minimized by tests with high degrees of sensitivity and specificity. The current study used a new test, the School-Age Sentence Imitation Test-English 32 (SASIT-E32), to investigate sentence repetition in monolingual and bilingual

  12. Congenital clavicular pseudoarthrosis associated with vascular thoracic outlet syndrome: case presentation and review of the literature.

    PubMed

    Hahn, K; Shah, R; Shalev, Y; Schmidt, D H; Bajwa, T

    1995-08-01

    Thoracic outlet syndrome (TOS) associated with congenital clavicular pseudoarthrosis is rare in adults and often misdiagnosed. In this case report, we describe an adult female who was found to have thrombosis of the subclavian and axillary arteries with embolization documented by invasive angiography. This unusual vascular manifestation of TOS should remind physicians that anatomic derangements may predispose to upper extremity ischemia. PMID:7497504

  13. Parasitic infections based on 320 clinical samples submitted to Hanyang University, Korea (2004-2011).

    PubMed

    Choi, Sung-Chul; Lee, Soo-Young; Song, Hyun-Ouk; Ryu, Jae-Sook; Ahn, Myoung-Hee

    2014-04-01

    We analyzed 320 clinical samples of parasitic infections submitted to the Department of Environmental Biology and Medical Parasitology, Hanyang University from January 2004 to June 2011. They consisted of 211 nematode infections, 64 trematode or cestode infections, 32 protozoan infections, and 13 infections with arthropods. The nematode infections included 67 cases of trichuriasis, 62 of anisakiasis (Anisakis sp. and Pseudoterranova decipiens), 40 of enterobiasis, and 24 of ascariasis, as well as other infections including strongyloidiasis, thelaziasis, loiasis, and hookworm infecions. Among the cestode or trematode infections, we observed 27 cases of diphyllobothriasis, 14 of sparganosis, 9 of clonorchiasis, and 5 of paragonimiasis together with a few cases of taeniasis saginata, cysticercosis cellulosae, hymenolepiasis, and echinostomiasis. The protozoan infections included 14 cases of malaria, 4 of cryptosporidiosis, and 3 of trichomoniasis, in addition to infections with Entamoeba histolytica, Entamoeba dispar, Entamoeba coli, Endolimax nana, Giardia lamblia, and Toxoplasma gondii. Among the arthropods, we detected 6 cases of Ixodes sp., 5 of Phthirus pubis, 1 of Sarcoptes scabiei, and 1 of fly larva. The results revealed that trichuriasis, anisakiasis, enterobiasis, and diphyllobothriasis were the most frequently found parasitosis among the clinical samples. PMID:24850969

  14. Helminth infections of the central nervous system occurring in Southeast Asia and the Far East.

    PubMed

    Lv, Shan; Zhang, Yi; Steinmann, Peter; Zhou, Xiao-Nong; Utzinger, Jrg

    2010-01-01

    Although helminth infections of the central nervous system (CNS) are rare, their public health implications must not be neglected. Indeed, several helminth species can cause cerebrospinal infections, especially if humans serve as intermediate or non-permissive host. The diagnosis of cerebrospinal helminthiases is difficult, and the detection of parasites in cerebrospinal fluid is rarely successful. Cerebrospinal helminth infections therefore often remain undetected, and hence prognosis is poor. Increases in tourism and population movements are risk factors for cerebrospinal helminthiases and infections pose particular challenges to clinicians in non-endemic areas. In this review, we focus primarily on food-borne helminthiases that are endemic and often emerging in Southeast Asia and the Far East, namely angiostrongyliasis, gnathostomiasis, sparganosis, paragonimiasis and cysticercosis. Additionally, we discuss neuroschistosomiasis, a disease that is transmitted through human-water contact. For each disease, we describe the pathogen, its transmission route and possible mechanisms for entering the CNS. We also summarise common signs and symptoms, challenges and opportunities for diagnosis, treatment, clinical management, geographical distribution and epidemiology. The adoption of a comprehensive set of diagnostic criteria for different cerebrospinal helminthiases is proposed, including epidemiological history, typical signs and symptoms, neuroimaging and laboratory findings. Finally, risk factors, and research needs for enhanced patient management and population-based control measures are discussed. PMID:20624537

  15. Parasitic Infections Based on 320 Clinical Samples Submitted to Hanyang University, Korea (2004-2011)

    PubMed Central

    Choi, Sung-Chul; Lee, Soo-Young; Song, Hyun-Ouk; Ryu, Jae-Sook

    2014-01-01

    We analyzed 320 clinical samples of parasitic infections submitted to the Department of Environmental Biology and Medical Parasitology, Hanyang University from January 2004 to June 2011. They consisted of 211 nematode infections, 64 trematode or cestode infections, 32 protozoan infections, and 13 infections with arthropods. The nematode infections included 67 cases of trichuriasis, 62 of anisakiasis (Anisakis sp. and Pseudoterranova decipiens), 40 of enterobiasis, and 24 of ascariasis, as well as other infections including strongyloidiasis, thelaziasis, loiasis, and hookworm infecions. Among the cestode or trematode infections, we observed 27 cases of diphyllobothriasis, 14 of sparganosis, 9 of clonorchiasis, and 5 of paragonimiasis together with a few cases of taeniasis saginata, cysticercosis cellulosae, hymenolepiasis, and echinostomiasis. The protozoan infections included 14 cases of malaria, 4 of cryptosporidiosis, and 3 of trichomoniasis, in addition to infections with Entamoeba histolytica, Entamoeba dispar, Entamoeba coli, Endolimax nana, Giardia lamblia, and Toxoplasma gondii. Among the arthropods, we detected 6 cases of Ixodes sp., 5 of Phthirus pubis, 1 of Sarcoptes scabiei, and 1 of fly larva. The results revealed that trichuriasis, anisakiasis, enterobiasis, and diphyllobothriasis were the most frequently found parasitosis among the clinical samples. PMID:24850969

  16. Mitochondrial Genome Sequences of Spirometra erinaceieuropaei and S. decipiens (Cestoidea: Diphyllobothriidae)

    PubMed Central

    Eom, Keeseon S.; Park, Hansol; Lee, Dongmin; Choe, Seongjun; Kim, Kyu-Heon; Jeon, Hyeong-Kyu

    2015-01-01

    The present study was performed to compare the mitochondrial genomes between 2 Spirometra tapeworms, Spirometra erinaceieuropaei and Spirometra decipiens (Cestoidea: Diphyllobothriidae), which larval stages are important etiological agents of sparganosis in humans. For each species, the full mitochondrial genome was amplified in 8 overlapping fragments using total genomic DNA purified from a single worm as the template. The mitochondrial genomes were 13,643 bp (S. erinaceieuropaei) and 13,641 bp (S. decipiens) in length and contained 36 genes; 12 protein-coding genes, 2 ribosomal RNA (rRNA, small and large subunits), and 22 transfer RNAs (tRNAs). The 12 protein-coding genes constituted 10,083 bp (S. erinaceieuropaei) and 10,086 bp (S. decipiens) of their respective mitochondrial genomes. The tRNA genes, ranging in length from 56 to 70 bp, were identified based on putative secondary structures such as the typical cloverleaf shape. A total of 23 intergenic sequences, varying from 1 to 204 bp in size, were interspersed in S. erinaceieuropaei (total, 504 bp) and S. decipiens (total, 496 bp) mtDNA. The 12 protein-coding genes of S. erinaceieuropaei and S. decipiens differed by 12.4%, whereas the overall difference in mtDNA sequence between S. erinaceieuropaei and S. decipiens was 12.9%. Thus, from the standpoint of the mitochondrial genome, S. decipiens represents a valid species that can be distinguished from S. erinaceieuropaei. PMID:26323844

  17. Zoonotic helminths affecting the human eye

    PubMed Central

    2011-01-01

    Nowaday, zoonoses are an important cause of human parasitic diseases worldwide and a major threat to the socio-economic development, mainly in developing countries. Importantly, zoonotic helminths that affect human eyes (HIE) may cause blindness with severe socio-economic consequences to human communities. These infections include nematodes, cestodes and trematodes, which may be transmitted by vectors (dirofilariasis, onchocerciasis, thelaziasis), food consumption (sparganosis, trichinellosis) and those acquired indirectly from the environment (ascariasis, echinococcosis, fascioliasis). Adult and/or larval stages of HIE may localize into human ocular tissues externally (i.e., lachrymal glands, eyelids, conjunctival sacs) or into the ocular globe (i.e., intravitreous retina, anterior and or posterior chamber) causing symptoms due to the parasitic localization in the eyes or to the immune reaction they elicit in the host. Unfortunately, data on HIE are scant and mostly limited to case reports from different countries. The biology and epidemiology of the most frequently reported HIE are discussed as well as clinical description of the diseases, diagnostic considerations and video clips on their presentation and surgical treatment. Homines amplius oculis, quam auribus credunt Seneca Ep 6,5 Men believe their eyes more than their ears PMID:21429191

  18. Characterization of the Complete Mitochondrial Genome Sequence of Spirometra erinaceieuropaei (Cestoda: Diphyllobothriidae) from China

    PubMed Central

    Liu, Guo-Hua; Li, Chun; Li, Jia-Yuan; Zhou, Dong-Hui; Xiong, Rong-Chuan; Lin, Rui-Qing; Zou, Feng-Cai; Zhu, Xing-Quan

    2012-01-01

    Sparganosis, caused by the plerocercoid larvae of members of the genus Spirometra, can cause significant public health problem and considerable economic losses. In the present study, the complete mitochondrial DNA (mtDNA) sequence of Spirometra erinaceieuropaei from China was determined, characterized and compared with that of S. erinaceieuropaei from Japan. The gene arrangement in the mt genome sequences of S. erinaceieuropaei from China and Japan is identical. The identity of the mt genomes was 99.1% between S. erinaceieuropaei from China and Japan, and the complete mtDNA sequence of S. erinaceieuropaei from China is slightly shorter (2 bp) than that from Japan. Phylogenetic analysis of S. erinaceieuropaei with other representative cestodes using two different computational algorithms [Bayesian inference (BI) and maximum likelihood (ML)] based on concatenated amino acid sequences of 12 protein-coding genes, revealed that S. erinaceieuropaei is closely related to Diphyllobothrium spp., supporting classification based on morphological features. The present study determined the complete mtDNA sequences of S. erinaceieuropaei from China that provides novel genetic markers for studying the population genetics and molecular epidemiology of S. erinaceieuropaei in humans and animals. PMID:22553464

  19. Infections Associated with Exotic Cuisine: The Dangers of Delicacies.

    PubMed

    Hochberg, Natasha S; Bhadelia, Nahid

    2015-10-01

    "Exotic" food dishes are an expression of regional culture, religion, and ethnicity worldwide. With the increase in international travel to remote areas of the world, globalization of the food supply, and changes in food habits, more people are consuming dishes once considered exotic. Such behavioral changes require awareness by consumers and clinicians about the risks of food-borne infections. This chapter addresses pathogens associated with consumption of raw or undercooked seafood including anisakidosis, Diphyllobothrium latum infection, flukes, and other infectious and toxin-mediated diseases. We discuss the geographic distribution of the pathogens, symptomatology, and basic principles of treatment. Food products derived from turtles, snakes, and other reptiles are reviewed, and we address the risk of gnathostomiasis, sparganosis, trichinellosis, and other pathogens. In discussing infections associated with undercooked beef, pork, and bush meat, we address dysentery, amebiasis, toxoplasmosis, Taenia infections, and risks of novel viral infections, among others. We also review infectious risks from poultry, dairy, and other food items, focusing on those organisms encountered less frequently by clinicians in developed countries. The wide range of infectious organisms related to exotic cuisine underscores the importance of educating the adventurous traveler and warrants continued vigilance on the part of the clinician. PMID:26542047

  20. Tomotherapy – a different way of dose delivery in radiotherapy

    PubMed Central

    Skórska, Małgorzata; Jodda, Agata; Ryczkowski, Adam; Kaźmierska, Joanna; Adamska, Krystyna; Karczewska-Dzionk, Aldona; Żmijewska-Tomczak, Małgorzata; Włodarczyk, Hanna

    2012-01-01

    Aim of the study Helical tomotherapy is one of the methods of radiotherapy. This method enables treatment implementation for a wide spectrum of clinical cases. The vast array of therapeutic uses of helical tomotherapy results directly from the method of dose delivery, which is significantly different from the classic method developed for conventional linear accelerators. The paper discusses the method of dose delivery by a tomotherapy machine. Moreover, an analysis and presentation of treatment plans was performed in order to show the therapeutic possibilities of the applied technology. Dose distributions were obtained for anaplastic medulloblastoma, multifocal metastases to brain, vulva cancer, tongue cancer, metastases to bones, and advanced skin cancer. Tomotherapy treatment plans were compared with conventional linear accelerator plans. Results Following the comparative analysis of tomotherapy and conventional linear accelerator plans, in each case we obtained the increase in dose distribution conformity manifested in greater homogeneity of doses in the radiation target area for anaplastic medulloblastoma, multifocal metastases to brain, vulva cancer, metastases to bones, and advanced skin cancer, and the reduction of doses in organs at risk (OAR) for anaplastic medulloblastoma, vulva cancer, tongue cancer, and advanced skin cancer. The time of treatment delivery in the case of a tomotherapy machine is comparable to the implementation of the plan prepared in intensity-modulated radiotherapy (IMRT) technique for a conventional linear accelerator. In the case of tomotherapy the application of a fractional dose was carried out in each case during one working period of the machine. For a conventional linear accelerator the total value of the fractional dose in the case of anaplastic medulloblastoma and metastases to bones was delivered using several treatment plans, for which a change of set-up was necessary during a fraction. Conclusion The obtained results confirm that tomotherapy offers the possibility to obtain precise treatment plans together with the simplification of the therapeutic system. PMID:23788850

  1. Isolation of a human papillomavirus from a patient with epidermodysplasia verruciformis: presence of related viral DNA genomes in human urogenital tumors.

    PubMed

    Green, M; Brackmann, K H; Sanders, P R; Loewenstein, P M; Freel, J H; Eisinger, M; Switlyk, S A

    1982-07-01

    The DNA genome of a human papillomavirus (HPV), tentatively designated HPV-EV, was molecularly cloned from hand to leg lesions of a patient with epidermodysplasia verruciformis, a chronic skin disease associated with a 30% risk of developing cancer. Using stringent hybridization conditions, we observed less than 5% homology between HPV-EV and the cloned genomes of HPV-1, HPV-4, HPV-5, and HPV-5a. HPV-EV DNA showed approximately 6% homology with HPV-2 and 36% homology with HPV-3. These data suggest that HPV-EV is partially related to HPV-3. Using 32P-labeled cloned HPV-EV as probe in Southern blot hybridization experiments, we detected HPV-EV-related DNA in the carcinoma in situ (Bowenoid lesion) of the vulva of the patient from which HPV-EV was isolated. HPV-EV-related DNA was detected in 2 of 10 vulva carcinomas and in 2 of 31 cervical carcinomas. Related DNA sequences were found in papillomas from each of two patients with condyloma acuminata (anogenital warts), which is of interest considering that condylomas have been reported to convert occasionally to carcinomas. The positive vulva DNAs were also probed with other cloned HPV DNAs: HPV-1, HPV-4, and HPV-5a-related sequences were not detected; HPV-3 and HPV-2 DNA probes detected strong and weak DNA bands, respectively, of the same size as found with HPV-EV. The HPV DNA sequences were present in the positive tumors mainly as free viral DNA molecules; no evidence for integration into cellular DNA was found. The emerging biological picture with papillomaviruses is that cells transformed by these viruses are maintained in a transformed state by free episomal genomes. Thus, our findings are consistent with the idea, but by no means establish, that HPVs play a role in human cancer by a similar mechanism. PMID:6289302

  2. Skrjabinura gnedina, 1933 (Nematoda: Seuratoidea: Seuratidae), in birds from the area de conservacion Guanacaste, Costa Rica with description of a new species.

    PubMed

    Zhang, Luping; Brooks, Daniel R

    2005-04-01

    Two species of Skrjabinura Gnedina, 1933, were collected in the intestines of birds from the Area de Conservación Guanacaste (ACG), Costa Rica. Skrjabinura mesoamericana n. sp. inhabits Dendrocincla homochroa, Calocitta formosa, Dendrocolaptes certhia, Basileuterus rufifrons, and Chordeiles acutipennis. The new species differs from all species of the genus by having dissimilar spicules, the right having a distinctive thin and bent handle on the proximal end. The new species can be further distinguished from Skrjabinura pomatostomi and Skrjabinura brevicaudatum by having subequal versus equal spicules. Skrjabinura mesoamericana resembles S. brevicaudatum in the number and arrangement of male caudal papillae but differs in the vulva position and in having smaller eggs. The new species differs from S. potamostomi in having 6 versus 8 pairs of postcloacal papillae. Among those species having subequal spicules, the new species further differs from Skrjabinura spiralis in having 1 pair of paracloacal papillae and 6 pairs of postcloacal papillae, versus no paracloacal papillae and 4 pairs of postcloacal papillae, and in the vulva position. The new species is perhaps most similar to Skrjabinura vali, from which it further differs by having 3 pairs of precloacal, 1 pair of paracloacal, and 6 pairs of postcloacal versus 2 pairs of precloacal, 2 pairs of paracloacal, and 6 pairs of postcloacal papillae in the vulva position and in the shape of the eggs. Skrjabinura vali (Guerrero, 1971) Chabaud, 1978, originally described in Piaya cayana from Venezuela, occurs in the small intestine of P. cayana, as well as the new hosts, Crotophaga sulcirostris and Myiarchus tyrannulus, in the ACG, a new locality. Our specimens differ from the original description in the body length of the female, the numbers of postanal papillae of male tail, and the size of eggs. PMID:15986622

  3. Aggressive Angiomyxoma with Perineal Herniation

    PubMed Central

    Narang, Seema; Kohli, Supreethi; Kumar, Vinod; Chandoke, Raj

    2014-01-01

    Aggressive angiomyxoma is a rare mesenchymal tumor involving the pelvic-perineal region. It occurs during the third and fourth decade of life and is predominantly seen in females. It presents clinically as a soft tissue mass in variable locations such as vulva, perianal region, buttock, or pelvis. Assessment of extent of the tumor by radiological evaluation is crucial for surgical planning; however, biopsy is essential to establish diagnosis. We present the radiological and pathological features seen in a 43-year-old female diagnosed with abdominal angiomyxoma with an unusual extension to the perineum. PMID:24987570

  4. Vulvovaginal laceration as a risk factor for uterine disease in postpartum dairy cows.

    PubMed

    Vieira-Neto, A; Lima, F S; Santos, J E P; Mingoti, R D; Vasconcellos, G S; Risco, C A; Galvao, K N

    2016-06-01

    The main objective was to evaluate the association between vulvovaginal laceration and uterine diseases in dairy cows. The secondary objectives were to evaluate the association between vulvovaginal laceration and cyclicity, and reproductive performance. The vulvovaginal region of 660 Holstein cows from a 5,000 lactating-cows herd was inspected at 4d in milk (DIM) for the presence of lacerations, and scored (VLS) as follows: 0=no laceration; 1=laceration <2cm at the dorsal commissure of the vulva or lateral walls of the vulva/vagina; 2=laceration ≥2cm at the dorsal commissure of the vulva or at the lateral walls of the vulva/vagina, or both. Vaginal discharge was scored at 4, 6, and 8 DIM for diagnosis of metritis, and then at 32 DIM for diagnosis of purulent vaginal discharge (PVD). Data were analyzed using LOGISTIC and PHREG procedures of SAS. Cows with VLS 2 had greater incidence of metritis than cows with VLS 0 (69.1 vs. 42.4%), and cows with VLS 1 tended to have greater incidence of metritis than cows with VLS 0 (52.0 vs. 42.4%). Cows with VLS 2 had greater incidence of PVD than cows with VLS 0 (56.5 vs. 43.1%). A lower proportion of cows with VLS 2 than VLS 0 were cyclic by 64 DIM (70.0 vs. 86.8%). A lower proportion of cows with VLS 2 than VLS 0 were pregnant at 60 d after first AI (28.7 vs. 33.6%). Proportion of pregnant cows at 60d after AI tended to be lower for VLS 1 than VLS 0 (28.4 vs. 33.6%). Hazard of pregnancy by 300 DIM was not affected by VLS. Hazard of pregnancy was decreased for cows with metritis, PVD, and anovular cows. In summary, vulvovaginal laceration was associated with uterine disease and cyclicity, which were negatively associated with reproductive performance. Vulvovaginal laceration was recognized as a risk factor for postpartum uterine disease. PMID:27016827

  5. Breast cancer with inguinal node recurrence.

    PubMed

    Goyal, Shikha; Puri, Tarun; Julka, Pramod K

    2015-03-01

    Surgery and irradiation for breast cancer may interfere with conventional pathways of spread, leading to bizarre patterns of dissemination through lymphatics or through hematogenous route. Lymphoscintigraphic studies may help identify nodal involvement. Other possible reasons could be occurrence of primary breast cancer in accessory breast tissue retained in the vulva following involution of milk line. We describe a case of triple negative breast cancer, who developed contralateral breast cancer during treatment. Three years later, she developed isolated inguinal nodal metastases, which responded to local radiotherapy and chemotherapy. However, the patient relapsed after 2 years and could not be salvaged thereafter. PMID:25455282

  6. Clinical features and plasma hormone levels after surgical menopause.

    PubMed

    Dennerstein, L; Wood, C; Hudson, B; Burrows, G

    1978-08-01

    This study reports the plasma levels of follicle stimulating hormone, luteinising hormone, oestradiol and testosterone in 43 women who had undergone bilateral oöphorectomy. Age was the only variable of those investigated which appeared to influence a hormone level; testosterone levels were found to decrease with increasing age. Two significant associations were found between clinical features of the menopause and the plasma hormone levels measured. Low levels of oestradiol were associated with pruritus vulvae and high levels of testerone were associated with headaches. PMID:283784

  7. Benign Vulvar Adnexal Tumours - A 5 year Study in a Tertiary Care Hospital

    PubMed Central

    Tiwana, Kanwardeep Kaur; Nibhoria, Sarita; Kaur, Harpreet; Bajaj, Akanksha; Phutela, Richa

    2015-01-01

    Despite of the fact that the vulva contains a high density of apocrine and anogenital mammary glands in addition to eccrine glands and folliculosebaceous units, the benign vulvar adnexal tumours are rare. Though the varied clinical presentation and diverse histopathological spectrum of vulvar neoplasms has amazed the pathologists, only few studies have been reported in literature. The present five year study consists of only five cases of benign vulvar neoplasms depicting their rarity. Hidradenoma papilliferum and syringoma were the most common entities followed by Chondroid syringoma. The aim of our study is to explore and highlight the histopathological diversity of benign vulvar adnexal tumours reflecting the relative frequency of these structures. PMID:27047567

  8. Proximal-type epithelioid sarcoma-unusual presentation: unilateral vulvar mass.

    PubMed

    Rodrigues, Ana Isabel; Lopes, Helena Isabel; Lima, Olinda; Marta, Susana

    2015-01-01

    Epithelioid sarcoma of the vulva is a very rare malignant soft tissue tumour, usually initially asymptomatic, which simulates a variety of benign lesions, leading to diagnosis only at later stages. Prognosis is generally poor. We report a case of a 55-year-old postmenopausal woman, who presented with rapid growth of an asymptomatic mass located in the left labia majora. Biopsy of the lesion revealed features characteristic of proximal-type epithelioid sarcoma. Ganglionar, adrenal, pulmonary and hepatic metastases were found at thoracoabdominopelvic CT scan. During hospitalisation, the patient's clinical condition suffered rapid deterioration and she died on the 16th day of admission. PMID:25858929

  9. Noninfectious genital ulcers.

    PubMed

    Kirshen, Carly; Edwards, Libby

    2015-12-01

    Noninfectious genital ulcers are much more common than ulcers arising from infections. Still, it is important to take a thorough history of sexual activity and a sexual abuse screen. A physical exam should include skin, oral mucosa, nails, hair, vulva, and vaginal mucosa if needed. The differential diagnosis of noninfectious genital ulcers includes: lipschütz ulcers, complex aphthosis, Behçet's syndrome, vulvar metastatic Crohn's disease, hidradenitis suppurativa, pyoderma gangrenosum, pressure ulcers, and malignancies. It is important to come to the correct diagnosis to avoid undue testing, stress, and anxiety in patients experiencing genital ulcerations. PMID:26650697

  10. Uterine endometrial polyp with severe hemorrhage and cystic endometrial hyperplasia-pyometra complex in a dog.

    PubMed

    Gumber, Sanjeev; Springer, Nora; Wakamatsu, Nobuko

    2010-05-01

    The current report describes an unusual presentation of uterine endometrial polyp with severe hemorrhage and cystic endometrial hyperplasia-pyometra complex in a 9.5-year-old female Doberman Pinscher. The dog presented with a 2-day history of bloody discharge from the vulva and an enlarged abdomen. The postmortem examination revealed a markedly distended right uterine horn with a large pedunculated mass (17 cm x 9 cm x 4 cm) and blood. Based on the histological findings, the diagnosis of uterine endometrial polyp was made. PMID:20453227

  11. Persistent vaginal haemorrhage in five mares caused by varicose veins of the vaginal wall.

    PubMed

    White, R A; Gerring, E L; Jackson, P G; Noakes, D E

    1984-09-15

    Persistent bleeding from the vulva was the only presenting clinical sign in five non-pregnant pluriparous mares varying in age from eight to 20 years. These were two hunter types, one shire, one thoroughbred and one Arab pony. The haemorrhage originated from ulcerated varicose veins present on the dorsal wall of the vagina adjacent to the vestibulovaginal junction. All five mares were successfully treated, by submucosal resection (two), ligation of vessels (two) or diathermy (one). In four mares there was evidence of vulval incompetence caused by depression of the perineum. The importance of this and the role of impaired venous return during and after pregnancy are discussed. PMID:6495576

  12. Hysteroscopy and episiotomy in a rescued, cold-stressed Florida manatee (Trichechus manatus latirostris) for diagnosis and treatment of a retained fetal skeleton.

    PubMed

    Hall, Natalie H; Walsh, Mike; DeLuca, Catherine; Bukoski, Alex

    2012-09-01

    A rescued female manatee was observed expelling a fetal bone from the vulva. The manatee was anesthetized and diagnosed with uterine retention of a fetal skeleton by ultrasound and hysteroscopy. Episiotomy was performed to gain manual access to the vagina and uterus for removal of the skeleton. Second intention healing of the episiotomy site produced excellent results. Rescued female manatees should receive a thorough reproductive tract evaluation since presence of retained fetal tissues might not be evident in blood or hormone analyses. Retention of a whole or partial dead fetus can be life-threatening to manatees, and retained tissues should be removed as early as possible. PMID:23082540

  13. A new species of Parafilaroides (Nematoda: Filaroididae) in three species of fur seals (Carnivora: Otariidae) from the Southern Hemisphere.

    PubMed

    Dailey, Murray D

    2009-02-01

    Blocks of frozen lungs of 2 Australian fur seals (Arctocephalus pusillus doriferus Wood Jones, 1925), 2 New Zealand fur seals (A. forsteri [Lesson, 1828]), and 1 sub-Antarctic fur seal (A. tropicalis [Gray, 1872]) from 3 different locations (Australia, New Zealand, and South Africa, respectively) were examined and found to contain lung parasites. This represents the first thorough description and identification of a new species, Parafilaroides normani, from an eared seal (Otariidae) in the Southern Hemisphere. The new species is described, illustrated, and differentiated from the 6 recognized species in the genus by body size, spicule shape and size, vulva to anus length, and vaginal sphincter musculature. PMID:18652523

  14. Chylous ascites: a sequel of pelvic radiation therapy

    SciTech Connect

    Sipes, S.L.; Newton, M.; Lurain, J.R.

    1985-12-01

    Chylous ascites is an unusual condition with many causes. Two cases are presented in which it appeared to be related to whole pelvis irradiation in one patient for carcinoma of the vagina and in another for carcinoma of the vulva. The diagnosis is made by paracentesis and analysis of the fluid. The underlying disease usually requires identification by exploratory laparotomy. Although a malignant process is the most common cause, the only findings in the authors' cases were widespread radiation changes in the intestine. After diagnosis treatment by low-fat diet with medium-chain triglyceride supplements resulted in disappearance of chylous ascites.

  15. [Congenital recto-vaginal fistula associated with a normal anus (type H fistula) and rectal atresia in a patient. Report of a case and a brief revision of the literature].

    PubMed

    Fernández Fernández, Jesús Ángel; Parodi Hueck, Luis

    2015-09-01

    Congenital recto-urogenital type fistulas with a normal anus and rectal atresia, represent both anorectal malformations that are infrequently seen in clinical practice. We describe the case of a girl with an association of these two anomalies, together with a double vagina who, on her seventh day of life, expelled feces through her genitals. The malformations were corrected by means of a posterior sagittal approach, descending from the rectum to the anus without perineal dissection. The vaginal septum was resected thru the vulva. There is no evidence of recurrence of the recto-vaginal fistula. PMID:26710545

  16. Vulvar lactating adenoma associated to a fibroadenoma: common neoplasms in an uncommon site

    PubMed Central

    Dhaoui, Amen; Nfoussi, Haifa; Kchir, Nidhameddine; Haouet, Slim

    2012-01-01

    Ectopic breast tissue is defined as glands located outside of the breast. Ectopic breast tissue should be excised because it may develop benign (fibroadenoma) or malignant pathologic processes. Less than forty cases of fibroadenomas have been reported in the literature. Although lactation changes can occur, lactating adenoma in the vulva are extremely rare. Only four cases have been reported. We report a case of a young woman who presented with vulvar mass during her lactation. The mass was excised, and histology confirmed vulvar lactating adenoma associated with fibroadenoma. This is the first case of vulvar heterotopic breast lesion associating lactating adenoma and fibroadenoma. PMID:23330038

  17. Restless Eating, Restless Legs, and Sleep Related Eating Disorder.

    PubMed

    Howell, Michael J

    2014-03-01

    Restless legs syndrome (RLS) often presents with a primary complaint of sleep initiation difficulty with only ambiguous allusions to motor symptoms. This may result in the condition being misdiagnosed as a psychophysiological insomnia. Further, nocturnal eating is common in RLS and like the classic motor symptoms, patients will describe an inability to initiate sleep until their urge (to eat) is addressed. Restless nocturnal eating arises, intensifies, and subsides in parallel to motor symptoms. Once misdiagnosed as psychophysiological insomnia, RLS patients are frequently treated with benzodiazepine receptor agonists. The CNS actions of these sedating agents, suppression of memory and executive function, unleash predisposed amnestic behaviors. In the case of RLS this would be expected to include the inappropriate ambulatory and eating behaviors of sleep related eating disorder (SRED). The evidence and implications of a link between the restless eating of RLS and SRED is presented here. PMID:26626472

  18. [Tick borne diseases].

    PubMed

    Holzer, B R

    2005-11-01

    It is known for many years that tick-borne diseases have worldwide a high economical impact on farming industry and veterinary medicine. But only in the last twenty years the importance of such diseases were notified in human medicine by the medical community and the public with emerging of the tick borne encephalitis virus and the description of Borrelia burgdorferi. It is often forgotten that many other infectious agents as bacteria, virus, Rickettsia or protozoa can be transmitted by ticks. Such diseases are rarely diagnosed in Europe either they are overlooked and misdiagnosed or they are connected with special professional activities. The development of new regions for tourism with different out door activities (adventure trips, trekking, hunting) leads to an exposure to different tick borne diseases, which are often misdiagnosed. PMID:16350539

  19. Laparoscopic duodenojejunostomy omega loop with braun anastomosis as a treatment for superior mesenteric artery syndrome.

    PubMed

    Alnabulsi, Baraa K; Miro, Jameel T; Faidah, Osama H; Hamo, Mahmoud A

    2011-02-01

    Superior mesenteric artery (SMA) syndrome is a rare clinical phenomenon caused by compression of the third portion of the duodenum by the overlying SMA, and can be easily misdiagnosed. We report a case of SMA syndrome treated with laparoscopic duodenojejunostomy omega loop with Braun anastomosis. A 24-year-old women with body mass index of 14.9 presented with a 4-year history of vague abdominal pain mainly at the epigastric region, radiating to the back associated with heartburn, repeated vomiting, and significant loss of weight during the previous 6 months. The case was misdiagnosed as acute pancreatitis. The SMA syndrome was diagnosed using CT-scan and fluoroscopy. Laparoscopic omega loop with Braun anastomosis was preformed. She did well postoperatively, and Gastrografin study showed no leak and a patent anastomosis. She was subsequently discharged on regular diet. PMID:21301768

  20. Detection of accidental oesophageal intubation. Role of the anaesthetic assistant.

    PubMed

    Cameron, A E; Hyde, R A; Sivalingam, P; Asbury, A J

    1997-08-01

    Three situations in which an anaesthetic assistant might be able to detect accidental oesophageal intubation during or immediately after intubation were assessed. These were: firstly, whilst applying cricoid pressure, secondly, whilst applying gentle palpation over the trachea just above the suprasternal notch and, thirdly, after intubation by means of a 'roll test'. During cricoid pressure, tracheal intubation was correctly diagnosed in all of 10 cases. However, deliberate oesophageal intubation was only detected in six out of 10 cases. During suprasternal palpation, three cases out of 10 oesophageal and three cases out of 10 tracheal intubation were misdiagnosed. In the 'roll test', two out of 10 tracheal and five out of 10 oesophageal intubations were misdiagnosed. In conclusion, no method could be relied on entirely and may indeed give false reassurance. Nonetheless, any doubt expressed about the tracheal tube position by the assistant should be taken seriously and a careful check made. PMID:9291756

  1. Lumbar Morel-Lavallée lesion: Case report and review of the literature.

    PubMed

    Zairi, F; Wang, Z; Shedid, D; Boubez, G; Sunna, T

    2016-06-01

    The Morel-Lavallée lesion (MLL) is a rarely reported closed degloving injury, in which shearing forces have lead to break off subcutaneous tissues from the underlying fascia. Lumbar MLL have been rarely reported to date, explaining that patients are frequently misdiagnosed. While patients could be treated conservatively or with non-invasive procedures, delayed diagnosis may require open surgery for its cure. Indeed, untreated lesions can cause pain, infection or growing subcutaneous mass that can be confused with a soft tissue tumor. We report the clinical and radiological features of a 45-year old man with voluminous lumbar MLL initially misdiagnosed. We also reviewed the relevant English literature to summarize the diagnostic tools and the main therapeutic options. PMID:26965645

  2. [Inverted Hyperplastic Polyp in Stomach: A Case Report and Literature Review].

    PubMed

    Lee, Yeon Ho; Joo, Moon Kyung; Lee, Beom Jae; Lee, Ji Ae; Kim, Taehyun; Yoon, Jin Gu; Lee, Jung Min; Park, Jong Jae

    2016-02-25

    An inverted hyperplastic polyp (IHP) found in stomach is rare and characterized by downward growth of hyperplastic mucosal component into the submucosa. Because of such characteristic, IHP can be misdiagnosed as subepithelial tumor or malignant tumor. In fact, adenocarcinoma was reported to have coexisted with gastric IHP in several previous reports. Because only 18 cases on gastric IHP have been reported in English and Korean literature until now, pathogenesis and clinical features of gastric IHP and correlation with adenocarcinoma have not been clearly established. Herein, we report a case of gastric IHP which was initially misdiagnosed as gastrointestinal stromal tumor and resected using endoscopic submucosal dissection. Literature review of previously published case reports on gastric IHP is also presented. PMID:26907486

  3. Isolated tubal torsion in the third trimester of pregnancy: A case report and review of the literature

    PubMed Central

    Sun, Yan; Liu, Ling-ling; Di, Jian-min

    2014-01-01

    Isolated torsion of a fallopian tube in the third trimester of pregnancy is an uncommon event. Its common symptoms are lower abdominal pain, vomiting, and nausea. Because these symptoms are nonspecific, isolated torsion of a fallopian tube may be misdiagnosed, delaying treatment and the opportunity to preserve the tube. This is a case report of a primipara in her third trimester, whowas misdiagnosed as having acute appendicitis and ovarian cyst torsion. The ultrasound-assisted examination was useful, but the specific diagnosis was made after laparotomy and histopathology. The patient was managed by simultaneous salpingectomy and cesarean section. This surgical intervention prevented adverse obstetric sequelae. We summarize our experience, provide our conclusions, and review 17 relevant studies from the literature to aid clinicians in understanding, diagnosing, and managing this condition in a timely fashion. PMID:25657760

  4. Pulmonary intravascular talcosis mimicking miliary tuberculosis in an intravenous drug addict

    PubMed Central

    Altraja, Alan; Jürgenson, Katre; Roosipuu, Retlav; Laisaar, Tanel

    2014-01-01

    Pulmonary foreign body granulomatosis following intravenous administration of medications meant for oral use among drug addicts has been occasionally reported. This condition is often misdiagnosed because of its rarity, but rather due to its similarity to other pulmonary diseases that are more common. Here we report a case of pulmonary intravascular talcosis mimicking miliary tuberculosis in a young male intravenous drug addict from North-Eastern Estonia, known as a hotspot for tuberculosis and drug misuse. The condition was caused by intravenous administration of crushed tablets of diphenhydramine, but miliary tuberculosis was misdiagnosed on patient's demographical, clinical and radiological grounds and a decision to start treatment with four first-line antituberculosis drugs followed. The current report refers to the importance of considering rare causes of pulmonary disseminations with attempts to identify the causative agent and warns against the use of antituberculosis treatment without confirmation of microbiological diagnosis of tuberculosis. PMID:24713715

  5. Mandibular Destruction Secondary to Invasion by Carcinoma Cuniculatum.

    PubMed

    Shapiro, Michael C; Wong, Brian; O'Brien, Michael J; Salama, Andrew

    2015-12-01

    Carcinoma cuniculatum is a rare form of well-differentiated squamous cell carcinoma that is often misdiagnosed. It has a propensity for local invasion and rarely metastasizes. Oral carcinoma cuniculatum is exceedingly rare, with very few reported cases in the English-language literature. Classically, its presentation mimics osteomyelitis or a dental abscess, resulting in misdiagnosis, multiple biopsy examinations, and procedures before a final diagnosis of carcinoma cuniculatum. This case report describes the case of a 71-year-old woman who was referred to the authors' clinic for evaluation of persistent pain and swelling of the mandible. Multiple biopsy examinations were negative for malignancy, and the patient was misdiagnosed with osteomyelitis and dental abscess before obtaining an accurate diagnosis of carcinoma cuniculatum. The aim of this report is to provide a thorough clinical and histopathologic report of carcinoma cuniculatum of the mandible, provide a brief review of the literature, and highlight the difficulties in arriving at this uncommon diagnosis. PMID:26072180

  6. Acute delirium in a critically ill patient may be a wolf in sheep’s clothing

    PubMed Central

    Lemyze, Malcolm; Favory, Raphael; Alves, Isabelle; Mathieu, Daniel

    2009-01-01

    Acute delirium is a commonly encountered problem in the intensive care unit (ICU), which has a myriad of causes and contributes to poor outcomes. We present the case of an alcoholic critically ill patient who developed prolonged acute ICU delirium wrongly diagnosed as sedation and alcohol withdrawal. Protracted vomiting, swallowing disorders and continuous aspirations prevented him from enteral feeding and discontinuation of mechanical ventilation. After several days, it became clear that the patient had been misdiagnosed. Fortunately, nystagmus and ophthalmoplegia then allowed the recognition of Wernicke’s encephalopathy, confirmed by cerebral MRIs. After thiamine supplementation, his state improved but he was discharged only on day 32. Wernicke’s encephalopathy is an acute reversible neuropsychiatric emergency, which is falsely considered as uncommon, and is largely misdiagnosed, especially in critically ill patients. Thiamine should be systematically given to all critically ill alcoholic patients, especially those with protracted vomiting. PMID:21686461

  7. Acute delirium in a critically ill patient may be a wolf in sheep's clothing.

    PubMed

    Lemyze, Malcolm; Favory, Raphael; Alves, Isabelle; Mathieu, Daniel

    2009-01-01

    Acute delirium is a commonly encountered problem in the intensive care unit (ICU), which has a myriad of causes and contributes to poor outcomes. We present the case of an alcoholic critically ill patient who developed prolonged acute ICU delirium wrongly diagnosed as sedation and alcohol withdrawal. Protracted vomiting, swallowing disorders and continuous aspirations prevented him from enteral feeding and discontinuation of mechanical ventilation. After several days, it became clear that the patient had been misdiagnosed. Fortunately, nystagmus and ophthalmoplegia then allowed the recognition of Wernicke's encephalopathy, confirmed by cerebral MRIs. After thiamine supplementation, his state improved but he was discharged only on day 32. Wernicke's encephalopathy is an acute reversible neuropsychiatric emergency, which is falsely considered as uncommon, and is largely misdiagnosed, especially in critically ill patients. Thiamine should be systematically given to all critically ill alcoholic patients, especially those with protracted vomiting. PMID:21686461

  8. “Rare or Underdiagnosed?” - Solitary Circumscribed Neuroma of the Lip

    PubMed Central

    2015-01-01

    Solitary circumscribed neuroma, also known as palisaded encapsulated neuroma is a benign neural tissue tumour. This is usually an asymptomatic and often misdiagnosed pathology in the head and neck region. Lip lesions have a broad differential diagnosis. Clinician’s awareness and accurate diagnosis are vital for their appropriate management. Here, we present a case report of solitary circumscribed neuroma of the lip, with a one year follow-up. PMID:26393228

  9. Anti-N-methyl-D-aspartate receptor encephalitis: A case report and review of the literature

    PubMed Central

    Kaur, Satnam; Juneja, Monica; Mishra, Devendra; Jain, Silky

    2014-01-01

    Anti-N-methyl-D-aspartate receptor encephalitis is a well characterized immune-mediated encephalitis. It is increasingly being recognized as one of the common causes of encephalitis, but is frequently misdiagnosed especially in resource-constrained settings. With a simple test available to diagnose the disorder and prospects of good recovery following early immunotherapy, the disorder should be kept as a differential diagnosis in patients presenting with unexplained behavioral/psychiatric symptoms and progressive encephalopathy with movement disorders. PMID:25250071

  10. Unraveling the Mystery Behind A Patient with ‘Refractory Seizures’

    PubMed Central

    Lahiri, Anadaroop; Kumar, Vipin; Manuel, Devi A; George, Oommen K

    2016-01-01

    Neurological manifestations such as seizures although rare are well recognized presentations of cardiac arrhythmias. Almost always, such events are primarily generalized in nature leading on to loss of consciousness. Rarely however, cardiac seizures can manifest with focal neurological events. We report a case of a sexagenarian who presented with recurrent focal seizures with secondary generalization, who was misdiagnosed and treated as seizure disorder; only a careful history and focussed investigations helped in realising a precise diagnosis.

  11. Hair casts

    PubMed Central

    Parmar, Sweta S.; Parmar, Kirti S.; Shah, Bela J.

    2014-01-01

    Hair casts or pseudonits are circumferential concretions, which cover the hair shaft in such a way that, it could be easily removed. They are thin, cylindrical, and elongated in length. We present an unusual case of an 8-year-old girl presenting with hair casts. Occurrence of these is unusual, and they may have varied associations. This patient was suffering from developmental delay. It is commonly misdiagnosed as and very important to differentiate from pediculosis capitis. PMID:25396168

  12. Oesophageal duplication cyst mimicking hydatid cyst in endemic areas.

    PubMed

    Akin, Melih; Erginel, Basak; Yildiz, Abdullah; Karadag, Cetin Ali; Sever, Nihat; Dokucu, Ali Ihsan

    2015-09-01

    The cystic appearance of both oesophageal duplications and pulmonary hydatid cysts can cause a misdiagnosis very easily due to rarity of cystic oesophageal duplications beside the higher incidence of hydatid cyst, especially in endemic areas. Here we report a 7-year-old girl with an oesophageal duplication cyst on the left side misdiagnosed as a hydatid cyst. The aim of the study is to report rare oesophageal duplications in the differential diagnosis of intrathoracic cysts. PMID:26702290

  13. Diagnostic Challenge of Desmoplastic Melanoma

    PubMed Central

    Andreevscaia, Olga; Theate, Ivan; Goossens, Cathy; Vanhooteghem, Olivier

    2016-01-01

    Desmoplastic melanoma (DM) is a rare variant of spindle-cell malignant melanoma. DM is easily misdiagnosed at an early stage because it can be confused with benign entities. Histological analysis, including careful attention to the presence of atypical spindle cells, as well as to lymphocytic aggregates in an abundant fibrotic stroma in the dermis, provides clues for diagnosis. The adjunction of an immunohistochemical panel, and particularly testing for S-100 protein, is needed for the final diagnosis. PMID:27134705

  14. [Accommodation insufficiency in children].

    PubMed

    Boschi, A; Bergmans, J; Moulaert, E; Spiritus, M

    1990-01-01

    Insufficiency of accommodation in children is often misdiagnosed, and particularly in preschool age. Subject if symptoms are unspecific, asthenopia, difficulties in nearwork, and for concentration. Differential diagnosis must be done between dyslexia, non refractive accommodative esotropia with high AC/A. In some cases we can't exclude the possibility of myasthenia even if this subject is still in discussion. The authors report two clinical cases of hypoaccommodation in children. PMID:2133535

  15. Femoral Nerve Palsy due to Anticoagulant Induced Retroperitoneal Hematoma

    PubMed Central

    Gurbuz, Orcun; Ercan, Abdulkadir; Kumtepe, Gencehan; Karal, İlker Hasan; Velioglu, Yusuf; Ener, Serdar

    2014-01-01

    A forty-one-year-old man who, sought evaluation for a sudden hip flexion contracture and groin pain with a history of mechanical mitral valve replacement, had been misdiagnosed and treated as having lumbar discopathy for two days. This patient finally was diagnosed with compressive femoral neuropathy due to warfarin-induced retroperitoneal hematoma and successfully managed nonoperatively. This case is reported in order to draw attention to this rare presentation. PMID:25386195

  16. The Misdiagnosis of Black Patients with Manic Depressive Illness

    PubMed Central

    Bell, Carl C.; Mehta, Harshad

    1980-01-01

    It has been shown repeatedly that, contrary to earlier beliefs, blacks may well demonstrate similar prevalence rates for manic depressive illness when compared with whites. Yet the authors believe that black manic depressive patients are frequently misdiagnosed as being chronic undifferentiated schizophrenics and treated with major tranquilizers when lithium is the drug of choice. This contention is supported by three case histories and some institutional dynamics that cause this form of iatrogenic morbidity to continue to prey upon black psychiatric patients. PMID:7365814

  17. Multilocular peritoneal inclusion cyst mimicking an ovarian tumor: A case report

    PubMed Central

    Singh, Anju; Sehgal, Alka; Mohan, Harsh

    2015-01-01

    Peritoneal inclusion cysts are uncommon abdominopelvic cysts seen in perimenopausal women. It is often misdiagnosed clinically as an ovarian tumor due to similar presentation and mimicking findings on radiology. We describe a perimenopausal woman presenting with pelvic mass. Her clinical finding on radiology suggested an ovarian tumor; however, biopsy revealed it as peritoneal inclusion cysts. We discuss the possible ways to avoid such mistakes. PMID:25861208

  18. Joint-sparing Corrections in Malunited Lisfranc Joint Injuries.

    PubMed

    Nery, Caio; Raduan, Fernando; Baumfeld, Daniel

    2016-03-01

    Lisfranc fracture-dislocations are very serious and potentially disabling injuries. Unfortunately, they are often misdiagnosed. Multiplanar midfoot deformities that result from these fracture-dislocations are precursors of joint degeneration and significant functional disabilities. Anatomic reduction with different types of internal fixation is an efficient method to reconstruct midfoot alignment and stability. Joint-preserving reconstruction techniques emerge as a viable alternative to corrective fusion as they achieve stable joint realignment with preserved motion. PMID:26915786

  19. Mucopolysaccharidosis type III (Sanfilippo syndrome) and misdiagnosis of idiopathic developmental delay, attention deficit/hyperactivity disorder or autism spectrum disorder

    PubMed Central

    Wijburg, Frits A; Węgrzyn, Grzegorz; Burton, Barbara K; Tylki-Szymańska, Anna

    2013-01-01

    Mucopolysaccharidosis III is a rare genetic disease characterized by progressive cognitive decline and severe hyperactivity that does not respond to stimulants. Somatic features are relatively mild. Patients are often initially misdiagnosed as having idiopathic developmental delay, attention deficit/hyperactivity disorder and/or autism spectrum disorders, putting them at risk for unnecessary testing and treatments. Conclusion: Children with developmental or speech delay, especially those with a characteristic somatic feature or behavioural abnormalities, should be screened for MPS III. PMID:23336697

  20. Metastatic sacrococcygeal yolk sac tumor: A misleading diagnosis

    PubMed Central

    Nsir, Atef Ben; Darmoul, Mehdi; Arous, Sarra Ben; Hattab, Nejib

    2015-01-01

    Sacrococcygeal yolk sac tumor (YST) is an extremely rare malignant extra-gonadal germ-cell tumor, which usually succeeds to the degeneration of more common benign teratoma. We describe here an unprecedented case of conus medullaris compression by a spinal metastasis from a pure sacrococcygeal YST in a 1½ years old girl, which was misdiagnosed initially as an anal fissure and stress the need of a meticulous clinical examination and further screening in young patients presenting with sphincter disturbances. PMID:26167024

  1. Metastatic sacrococcygeal yolk sac tumor: A misleading diagnosis.

    PubMed

    Ben Nsir, Atef; Darmoul, Mehdi; Arous, Sarra Ben; Hattab, Nejib

    2015-01-01

    Sacrococcygeal yolk sac tumor (YST) is an extremely rare malignant extra-gonadal germ-cell tumor, which usually succeeds to the degeneration of more common benign teratoma. We describe here an unprecedented case of conus medullaris compression by a spinal metastasis from a pure sacrococcygeal YST in a 1½ years old girl, which was misdiagnosed initially as an anal fissure and stress the need of a meticulous clinical examination and further screening in young patients presenting with sphincter disturbances. PMID:26167024

  2. Surgical management of peripheral variant of adenomatoid odontogenic tumor: A rare case report with review

    PubMed Central

    Jindwani, Karuna; Paharia, Y. K.; Kushwah, Atul Pratap Singh

    2015-01-01

    The adenomatoid odontogenic tumour (AOT) is a relatively uncommon lesion constituting around 3% of all odontogenic tumours and often misdiagnosed as an odontogenic cyst. It manifests as a beningn growth which affects young individuals, with a female predeliction usually in the second decade of life, exhibiting more often in the anterior region of maxilla. The current article enumerates the clinical, radiographic and histopathological features of a rare case of extraosseous AOT with its therapeutic consideration PMID:25684929

  3. Disseminated paracoccidioidomycosis diagnosis based on oral lesions

    PubMed Central

    Webber, Liana Preto; Martins, Manoela Domingues; de Oliveira, Márcia Gaiger; Munhoz, Etiene Andrade; Carrard, Vinicius Coelho

    2014-01-01

    Paracoccidioidomycosis (PCM) is a deep mycosis with primary lung manifestations that may present cutaneous and oral lesions. Oral lesions mimic other infectious diseases or even squamous cell carcinoma, clinically and microscopically. Sometimes, the dentist is the first to detect the disease, because lung lesions are asymptomatic, or even misdiagnosed. An unusual case of PCM with 5 months of evolution presenting pulmonary, oral, and cutaneous lesions that was diagnosed by the dentist based on oral lesions is presented and discussed. PMID:24963249

  4. Giant Seborrheic Keratosis of the Genitalia

    PubMed Central

    Nath, Amiya Kumar; Kumari, Rashmi; Rajesh, G; Thappa, Devinder Mohan; Basu, Debdatta

    2012-01-01

    Genital seborrheic keratosis (SK) is a rare entity, which can be easily misdiagnosed as genital warts. Dermoscopy is a useful tool to make diagnosis of SK in such cases. We report a 50-year-old woman with a large polypoidal growth on the external genitalia. Dermoscopic examination showed fissures and ridges, cerebriform appearance, and comedo-like openings consistent with SK. The histopathology confirmed the diagnosis of SK. PMID:22837573

  5. An unusual presentation of a dural arteriovenous fistula of the sphenoparietal sinus

    PubMed Central

    Macdonald, Andrew; Plaha, Puneet; Byrne, James

    2014-01-01

    Dural arteriovenous fistulae (DAVFs) are a rare form of intracranial arteriovenous malformation. We present the case of a patient who presented in a previously undescribed manner with facial swelling and bruising initially misdiagnosed as cellulitis. He was found subsequently to have DAVFs of the sphenoparietal sinus that had hemorrhaged. The rarity of DAVFs at this location may account for this unique presentation. Successful treatment was achieved by transarterial embolization. PMID:24632907

  6. Oesophageal duplication cyst mimicking hydatid cyst in endemic areas

    PubMed Central

    Akin, Melih; Yildiz, Abdullah; Karadag, Cetin Ali; Sever, Nihat; Dokucu, Ali Ihsan

    2015-01-01

    The cystic appearance of both oesophageal duplications and pulmonary hydatid cysts can cause a misdiagnosis very easily due to rarity of cystic oesophageal duplications beside the higher incidence of hydatid cyst, especially in endemic areas. Here we report a 7-year-old girl with an oesophageal duplication cyst on the left side misdiagnosed as a hydatid cyst. The aim of the study is to report rare oesophageal duplications in the differential diagnosis of intrathoracic cysts. PMID:26702290

  7. Mature brain tissue in the sacrococcygeal region

    PubMed Central

    Shrestha, Binod Bade; Ghimire, Pradeep; Ghartimagar, Dilasma; Jwarchan, Bishnu; Lalchan, Subita; Karmacharya, Mikesh

    2016-01-01

    Complete mature brain tissue in sacrococcygeal region is a rare congenital anomaly in a newborn, which usually is misdiagnosed for sacrococcygeal teratoma. Glial tumor-like ependymoma is also common in sacrococcygeal area but mostly appears later in life. We present a case of complete heterotopic brain tissue in the sacrococcygeal region. The patient underwent total excision of mass with coccygectomy. To our knowledge it is the second case being reported. PMID:27194682

  8. Late Onset Traumatic Diaphragmatic Herniation Leading to Intestinal Obstruction and Pancreatitis: Two Separate Cases

    PubMed Central

    Dinc, Tolga; Kayilioglu, Selami Ilgaz; Coskun, Faruk

    2015-01-01

    Although diaphragmatic injuries caused by blunt or penetrating trauma are rare entities, they are the most commonly misdiagnosed injuries in trauma patients and occur in approximately 3–7% of all abdominal or thoracic traumas. Acute pancreatitis secondary to late presenting diaphragmatic hernia is very rare. Here we present two separate cases: one with acute bowel obstruction and the other with acute pancreatitis secondary to late onset traumatic diaphragmatic hernia (three and twenty-eight years after chest trauma, resp.). PMID:26380126

  9. Lymphomatosis Cerebri

    PubMed Central

    Lee, Chae-Heuck; Joo, Mee

    2013-01-01

    Lymphomatosis cerebri is considered a diffuse form of primary central nervous system lymphoma and very rare. It is not well recognized and may be misdiagnosed with infiltrating tumors, degenerative disorders, ischemic diseases, and infectious diseases developed in the brain. Awareness of the possibility of this rare disease and early biopsy are required for differential diagnosis and preventing poor clinical outcomes. We report a case with lymphomatosis cerebri who presented with rapid neurological deteriorations and review the relevant literatures. PMID:24379950

  10. Acute Legionella pneumophila infection masquerading as acute alcoholic hepatitis

    PubMed Central

    Hunter, Jonathan Michael; Chan, Julian; Reid, Angeline Louise; Tan, Chistopher

    2013-01-01

    A middle-aged man had deteriorated rapidly in hospital after being misdiagnosed with acute alcoholic hepatitis. Acute Legionnaires disease (Legionellosis) was subsequently diagnosed on rapid antigen urinary testing and further confirmed serologically. This led to appropriate antibiotic treatment and complete clinical resolution. Physicians caring for patients with alcohol-related liver disease should consider Legionella pneumophila in their differential diagnosis even with a paucity of respiratory symptoms. PMID:23355576

  11. Epithelioid Trophoblastic Tumor in a Postmenopausal Woman: A Case Report

    PubMed Central

    Park, Jung-Woo

    2016-01-01

    Epithelioid trophoblastic tumor (ETT) is a rare gestational trophoblastic neoplasm composed of intermediate trophoblasts. Most cases of ETT are reported in women of reproductive age following a prior gestation within 2 weeks to 30 years. ETT is extremely rare in postmenopausal women. It is commonly misdiagnosed as a poorly differentiated carcinoma or another type of gestational trophoblastic tumor. We report a case of ETT in a 56-year-old woman that developed 23 years after the patient's last pregnancy. PMID:27152314

  12. Three Different Dermoscopic View of Three New Cases with Pilomatrixoma

    PubMed Central

    Ayhan, Erhan; Ertugay, OC; Gundogdu, R

    2014-01-01

    Pilomatrixoma is a benign soft tissue neoplasm originated from follicular matrix of hair and is also known as Malherbe's calcified epithelioma. Some lesions are located on the skin and are usually misdiagnosed. A small number of patients had been dermoscopically examined. In this article, three patients of pilomatrixoma who had three different dermoscopic views were evaluated and discussed in concordance with the literature. PMID:25114449

  13. Managing the Unexpected: Complexity as Distributed Sensemaking

    NASA Astrophysics Data System (ADS)

    Weick, Karl E.

    In 1998 the Centers for Disease Control (CDC) published a statement of their strategy entitled "Preventing Emerging Infectious Diseases: A Strategy for the 21st Century." They described their central challenge this way: "because we do not know what new diseases will arise, we must always be prepared for the unexpected" (p. vii). Soon after they published that statement CDC was confronted with an unexpected emerging disease, the West Nile Virus, which they misdiagnosed initially.

  14. Delivery Induced Intraperitoneal Rupture of a Cystic Ovarian Teratoma and Associated Chronic Chemical Peritonitis

    PubMed Central

    Nader, Reine; Thubert, Thibault; Deffieux, Xavier; de Laveaucoupet, Jocelyne; Ssi-Yan-Kai, Guillaume

    2014-01-01

    Intraperitoneal rupture of cystic ovarian teratoma is a rare complication. We report a case in a 29-year-old female, with increased abdominal circumference 2 months after vaginal delivery. MRI/CT raised this diagnosis associated to chemical peritonitis. A malignant ovarian mass with peritoneal carcinomatosis was excluded. Laparoscopic oophorectomy was performed and histologic analysis confirmed imaging findings. This case demonstrates the interest of imaging before surgery in pelvic masses to avoid misdiagnosing and to provide adequate treatment. PMID:24744942

  15. Gallbladder Cancer Presenting with Brain and Bone Metastasis: Case Report

    PubMed Central

    Singh, Manish; Karmakar, Shilpi; Karmakar, Saurabh

    2015-01-01

    Although gallbladder cancer is a rare disease worldwide, north India has one of the highest incidences of this disease. We report a case of asymptomatic gall bladder cancer with brain metastasis. The patient presented with a scalp lump as the sole presenting feature, with no symptoms attributable to abdominal malignancy. Previously, the lump had been incised by a local practitioner who had probably misdiagnosed it as an abscess. PMID:25954661

  16. Misdiagnosis of menstruation-related recurrent hypersomnia as epilepsy in a patient with generalized epileptic discharges

    PubMed Central

    Benbir, Gulcin; Delil, Sakir; Karadeniz, Derya; Yeni, Naz

    2015-01-01

    Recurrent hypersomnias are very rare with two subtypes as Kleine–Levin syndrome and menstruation-related hypersomnia, which is very rarely encountered worldwide. Here, we report a young girl with menstruation-related recurrent hypersomnia, who was misdiagnosed as epilepsy due to co-existing generalized epileptic discharges. The importance of this comorbidity in terms of differential diagnosis of the attacks is discussed. PMID:25878739

  17. Misdiagnosis of menstruation-related recurrent hypersomnia as epilepsy in a patient with generalized epileptic discharges.

    PubMed

    Benbir, Gulcin; Delil, Sakir; Karadeniz, Derya; Yeni, Naz

    2015-01-01

    Recurrent hypersomnias are very rare with two subtypes as Kleine-Levin syndrome and menstruation-related hypersomnia, which is very rarely encountered worldwide. Here, we report a young girl with menstruation-related recurrent hypersomnia, who was misdiagnosed as epilepsy due to co-existing generalized epileptic discharges. The importance of this comorbidity in terms of differential diagnosis of the attacks is discussed. PMID:25878739

  18. A Case of Reed's Syndrome: An Underdiagnosed Tumor Disorder

    PubMed Central

    Kontochristopoulos, Georgios; Kouris, Anargyros; Balamoti, Evgenia; Vavouli, Charitomeni; Markantoni, Vasiliki; Christofidou, Elefteria; Antoniou, Christina

    2014-01-01

    Cutaneous leiomyomas are uncommon, benign smooth muscle tumors originating from the arrector pili muscle of the hair follicle that are frequently unrecognized and underdiagnosed by clinicians. They sometimes coexist with common uterine fibroids in an inherited disorder named multiple cutaneous and uterine leiomyomatosis, also referred to as Reed's syndrome. We report a case of Reed's syndrome in a young woman who had been misdiagnosed for many years. PMID:25232316

  19. Gastrointestinal stromal tumours (GISTs) with a thousand faces: atypical manifestations and causes of misdiagnosis on imaging.

    PubMed

    Kim, S W; Kim, H C; Yang, D M; Won, K Y

    2016-02-01

    Gastrointestinal stromal tumours (GISTs) can lead to emergency situations, such as gastrointestinal bleeding, intestinal obstruction, and tumoural rupture with haemoperitoneum or peritonitis. In addition, if a GIST grows exophytically to a large size, it is often misdiagnosed as a tumour arising from adjacent organs. Sometimes, the atypical appearance of GISTs on imaging causes diagnostic confusion. In this article, we illustrate a variety of GISTs with atypical presentations and also discuss the important diagnostic clues for differentiating GISTs from other lesions. PMID:26646370

  20. Wrist Tenosynovitis due to Mycobacterium bovis Infection: Case Series and Review of the Literature

    PubMed Central

    Güner, Mehmet Derviş; Bektaş, Umut; Akmeşe, Ramazan; Armangil, Mehmet; Ay, Şadan

    2014-01-01

    Summary: Tuberculosis infections are still one of the most important public health problems among developing countries. Musculoskeletal involvement represents 10–15% of all extrapulmonary cases. Tuberculosis tenosynovitis is usually misdiagnosed as nonspecific tenosynovitis. To avoid misdiagnosis and mistreatment, it is important to be alert for mycobacterial infections. This article presents 3 patients with wrist tenosynovitis, which was caused by Mycobacterium bovis infection. The article also includes review of the literature. PMID:25587496

  1. [Back to the emergency department with a painful ankle].

    PubMed

    van Egmond, Pim W; van de Rest, Hendrik J M; Nolte, Peter A

    2014-01-01

    A 31-year-old woman came to the Emergency Department with a painful ankle 2 days after a fall off a horse. On the day of the accident, she was misdiagnosed with a lateral ankle sprain. A lateral X-ray of the ankle showed a positive 'V-sign', which is pathognomonic for a fracture of the lateral process of the talus. PMID:24713340

  2. Lime-induced phytophotodermatitis

    PubMed Central

    Hankinson, Andrew; Lloyd, Benjamin; Alweis, Richard

    2014-01-01

    This case describes a scenario of lime-induced phytophotodermatitis. Phytophotodermatitis is a dermatitis caused after the skin is exposed to photosensitizing compounds in plants and then exposed to sunlight. Many common plants including citrus fruits, celery, and wild parsnip contain these photosensitizing compounds which cause phytophotodermatitis. It is important for a physician to be aware of phytophotodermatitis because it may often be misdiagnosed as other skin conditions including fungal infection, cellulitis, allergic contact dermatitis, and even child abuse. PMID:25317269

  3. Lime-induced phytophotodermatitis.

    PubMed

    Hankinson, Andrew; Lloyd, Benjamin; Alweis, Richard

    2014-01-01

    This case describes a scenario of lime-induced phytophotodermatitis. Phytophotodermatitis is a dermatitis caused after the skin is exposed to photosensitizing compounds in plants and then exposed to sunlight. Many common plants including citrus fruits, celery, and wild parsnip contain these photosensitizing compounds which cause phytophotodermatitis. It is important for a physician to be aware of phytophotodermatitis because it may often be misdiagnosed as other skin conditions including fungal infection, cellulitis, allergic contact dermatitis, and even child abuse. PMID:25317269

  4. Traumatic fracture-dislocation of the hip following rugby tackle: a case report.

    PubMed

    Venkatachalam, Santosh; Heidari, Nima; Greer, Tony

    2009-01-01

    Posterior fracture-dislocation of hip is uncommonly encountered in rugby injuries. We report such a case in an adult while playing rugby. The treating orthopaedician can be caught unaware and injuries in such sports can be potentially misdiagnosed as hip sprains. Immediate reduction of the dislocation was performed in theatres. The fracture was fixed with two lag screws and a neutralization plate. This led to early rehabilitation and speedy recovery with return to sporting activities by 12 months. PMID:20003496

  5. Generalized hair casts due to traction.

    PubMed

    Ozuguz, Pinar; Kacar, Seval; Takci, Zennure; Ekiz, Ozlem; Kalkan, Goknur; Bulbul Sen, Bilge

    2013-01-01

    Peripilar keratin casts, also called pseudonits or hair casts, are thin, elongated, greyish-white, cylindrical, sleeve-like structures that encircle the hair shaft and can easily be slid along the hair. They may be clinically misdiagnosed as nits. In addition to physical removal, keratolytic lotions or shampoos are helpful. We report an 11-year-old girl with pseudonits. Although it is not a rare condition, underdiagnosis is common. PMID:23909653

  6. Unruptured pregnancy in a noncommunicating rudimentary horn at 37 weeks with a live fetus: a case report.

    PubMed

    Cheng, Chen; Tang, Weiwei; Zhang, Lei; Luo, Mei; Huang, Meihua; Wu, Xiuling; Wan, Guiping

    2015-01-01

    We report an extremely rare case of an unruptured non-communicating rudimentary horn full-term pregnancy. A woman who had a uterine malformation was misdiagnosed as uterus didelphys and gave birth to a live, healthy fetus. The correct diagnosis was not made until cesarean section at 37 4/7 weeks. The case suggests that women who are pregnant in a rudimentary horn could obtain a full-term delivery and give birth to a live and healthy baby. PMID:25745480

  7. Zika fever imported from Thailand to Japan, and diagnosed by PCR in the urines.

    PubMed

    Shinohara, Koh; Kutsuna, Satoshi; Takasaki, Tomohiko; Moi, Meng Ling; Ikeda, Makiko; Kotaki, Akira; Yamamoto, Kei; Fujiya, Yoshihiro; Mawatari, Momoko; Takeshita, Nozomi; Hayakawa, Kayoko; Kanagawa, Shuzo; Kato, Yasuyuki; Ohmagari, Norio

    2016-01-01

    In July 2014, a Japanese traveller returning from Thailand was investigated for fever, headache, rash and conjunctivitis. Zika virus RNA was detected in his urine sample by real-time reverse transcription polymerase chain reaction. Serological tests showed cross reactivity of IgM against the dengue virus. Zika fever could be misdiagnosed or missed and should be considered in febrile patients with a rash, especially those returning from Thailand. PMID:26782128

  8. Vacation Hazards For Travellers in Tropical, Sub-Tropical and Underdeveloped Countries

    PubMed Central

    Lenczner, Michael M.; Smith, David R. F.

    1972-01-01

    This is a three part article covering the kinds of diseases imported from tropical countries, the advice which should be given to patients about to travel in these countries, and a schedule of immunization procedures to begin two months before departure date. The authors give descriptions of the symptoms and treatment of diseases which are seen in their hospital and which can easily be misdiagnosed by the family physician who does not encounter them regularly. Images12345678910111213141516 PMID:20468768

  9. Dipylidium caninum in a 4-month old male.

    PubMed

    Taylor, Tabitha; Zitzmann, Michele B

    2011-01-01

    Dipylidium caninum, known as the double-pored dog tapeworm, is a parasite that commonly infects dogs and cats worldwide. Humans may be an accidental host if the infective stage, the cysticercoid larva, is ingested. Although rare, it is more commonly seen in infants and children. This case study involves an infant misdiagnosed with pinworm infection twice before a laboratory evaluation was able to confirm Dipylidium caninum. Accurate diagnosis is important, as treatment for pinworm infection will not eliminate Dipylidium caninum. PMID:22288218

  10. Fracture epiphyseal separation of the distal humerus.

    PubMed

    Sen, R K; Bedi, G S; Nagi, O N

    1998-08-01

    Seven patients seen with fracture separation of the distal humerus epiphysis have been analysed for the problems linked with the radiological diagnosis of this injury. Peculiar male predominance, exclusive left-side involvement, consistent postero-medial displacement of the epiphyseal fragment and ability to achieve near anatomic reduction by closed manipulation in fresh cases have been some of the other features observed. The literature has been briefly reviewed for this infrequent and usually misdiagnosed injury. PMID:9727266

  11. Juxta-adrenal Ancient Schwannoma: A Rare Retroperitoneal Tumor

    PubMed Central

    Wollin, Daniel A; Sivarajan, Ganesh; Shukla, Pratibha; Melamed, Jonathan; Huang, William C; Lepor, Herbert

    2015-01-01

    Retroperitoneal schwannoma is a rare tumor that is often misdiagnosed as malignancy due to a concerning appearance on cross-sectional imaging. Pathology and immunohistochemistry form the gold standard for diagnosis; as such, local excision is the treatment of choice for this disease. We present two cases of juxta-adrenal ancient schwannoma that were treated with adrenalectomy and discuss the current literature regarding this entity.

  12. A Striking Coronary Artery Pattern in a Grown-Up Congenital Heart Disease Patient

    PubMed Central

    Iacovelli, Fortunato; Pepe, Martino; Contegiacomo, Gaetano; Alberotanza, Vito; Masi, Filippo; Bortone, Alessandro Santo; Favale, Stefano

    2016-01-01

    Left ventricular noncompaction (LVNC) is a myocardial disorder probably due to the arrest of normal embryogenesis of the left ventricle. It could be isolated or associated with other extracardiac and cardiac abnormalities, including coronary artery anomalies. Despite the continuous improvement of imaging resolution quality, this cardiomyopathy still remains frequently misdiagnosed, especially if associated with other heart diseases. We report a case of LVNC association with both malposition of the great arteries and a very original coronary artery pattern. PMID:26881144

  13. Hypocretinergic dysfunction in neuromyelitis optica with coma-like episodes

    PubMed Central

    Carlander, B; Vincent, T; Le Floch, A; Pageot, N; Camu, W; Dauvilliers, Y

    2009-01-01

    Devic’s neuromyelitis optica (NMO) is a severe demyelinating disease of the central nervous system, often misdiagnosed as multiple sclerosis, and involving mainly optic nerves and the spinal cord. We report on a peculiar case of relapsing NMO with severe recurrent dysautonomia and hypersomnia, in which we had the opportunity to observe a dramatic decrease in hypocretin/orexin cerebrospinal fluid level. PMID:21686670

  14. Schizoaffective Disorder With Missed Diagnosis of Acute Porphyria: A Case Report and Overview

    PubMed Central

    Bennett, Jeffrey I.; Resch, David S.; Godwin, John E.

    2011-01-01

    Acute porphyrias are often misdiagnosed and most commonly present as atypical neuropsychiatric symptoms or acute abdominal pain. Clinicians should suspect acute porphyrias in patients presenting with variable neuropsychiatric symptoms and unexplained pain. Proper identification can lead to less iatrogenicity associated with porphyrinogenic agents, appropriate management, and a better patient outcome. The case of a patient with hereditary coproporphyria, one of the acute porphyrias, is presented to illustrate the broad manifestations, unsuspected diagnosis, and difficulties in management. PMID:22454794

  15. Schizoaffective disorder with missed diagnosis of acute porphyria: a case report and overview.

    PubMed

    Jain, Gaurav; Bennett, Jeffrey I; Resch, David S; Godwin, John E

    2011-01-01

    Acute porphyrias are often misdiagnosed and most commonly present as atypical neuropsychiatric symptoms or acute abdominal pain. Clinicians should suspect acute porphyrias in patients presenting with variable neuropsychiatric symptoms and unexplained pain. Proper identification can lead to less iatrogenicity associated with porphyrinogenic agents, appropriate management, and a better patient outcome. The case of a patient with hereditary coproporphyria, one of the acute porphyrias, is presented to illustrate the broad manifestations, unsuspected diagnosis, and difficulties in management. PMID:22454794

  16. Vulval intestinal/enteric heterotopia with a 10-yr follow-up: a case report and review of the literature.

    PubMed

    Horn, Lars-Christian; Bauerfeind, Ursula Katharina; Strau, Hans-Georg; Karbe, Ina

    2014-05-01

    The occurrence of ectopic intestinal/enteric-type epithelium at the vulva is a rare entity sometimes mimicking intraepithelial neoplasia or malignant disease. Here, we report a case of an 82-yr-old woman with a long-standing (10 yr) white papillary lesion with some reddish areas at her left labium, extending into the vaginal introitus. Biopsy reports revealed colonic-type glandular epithelium with positive immunostaining against CDX-2, p53, CK 7, and CEA, whereas staining against estrogen and progesterone receptor, mammoglobin, GCDFP-15, and CK 20 was reported to be negative. A follow-up of 10 yr appeared uneventful. The occurrence of celomic-type glandular epithelium at the vulva may represent the result of dysontogenetic replacement of embryonic stem cells, which undergo mucinous differentiation. Thus, the proper diagnostic term may be glandular heterotopia. Although some lesions, especially in the proximity to orthotopic vulval glands, may be of metaplastic origin. Immunohistochemical staining patterns (CEA, CK 7 positive, and CK 20 negative) indicate an intestinal/enteric phenotype (i.e. intestinal/enteric heterotopia). Because of the reported increased risk of malignant transformation of glandular vulval lesions, close clinical follow-up is recommended. PMID:24681736

  17. Incidence Patterns and Temporal Trends of Invasive Nonmelanotic Vulvar Tumors in Germany 1999-2011. A Population-Based Cancer Registry Analysis

    PubMed Central

    Buttmann-Schweiger, Nina; Klug, Stefanie J.; Luyten, Alexander; Holleczek, Bernd; Heitz, Florian; du Bois, Andreas; Kraywinkel, Klaus

    2015-01-01

    Objectives Time trends on the incidence and characteristics of invasive vulvar cancer in Germany have so far been studied in few local population- and hospital based tumor registries. We aimed to provide an overview on recent developments of vulvar cancer in Germany, using population-based cancer registry data. Methods We analyzed the data on vulvar cancer of eight population-based German cancer registries for the period 1999-2011. ICD-10 codes and ICD-O-3 morphology codes were used to select site and histologic types. The annual percentage change was calculated on age-adjusted incidence rates with a joinpoint regression model. Results A total of 12,711 registered cases of invasive carcinoma of the vulva were included in the analyses, hereof were 12,205 of squamous cell origin. Age-standardized incidence rates of vulvar cancer annually increased by 6.7% (95% confidence limits: 5.6-7.9) from 1.7 per 100,000 women in 1999 to 3.6 per 100,000 women in 2011. An increase was observed among women of all ages, and especially between 30 and 69 years of age. Conclusion The annual incidence of invasive carcinoma of the vulva nearly doubled in the past decade in Germany, considerably exceeding the rates observed in other Western European countries. A combination of changes in risk factors, and documentation practice might have contributed to the observed substantial increase in vulvar cancer incidence. PMID:26020540

  18. Increased Risk of Endometriosis in Patients With Lower Genital Tract Infection: A Nationwide Cohort Study.

    PubMed

    Lin, Wu-Chou; Chang, Cherry Yin-Yi; Hsu, Yu-An; Chiang, Jen-Huai; Wan, Lei

    2016-03-01

    Endometriosis results from the ectopic invasion of endometrial glands and stroma in the peritoneal cavity. The exact etiology of endometriosis is still unknown. It has, however, been shown that there are higher numbers of Escherichia coli in menstrual blood, and higher endotoxin levels in menstrual fluid, as well as, in the peritoneal fluid of patients with endometriosis. In this study, we aimed to determine whether lower genital tract infections could increase the risk of endometriosis.We used the Taiwan National Health Insurance database to conduct a population-based cohort study. We included patients diagnosed with inflammatory diseases of the cervix, vagina, and vulva, and a control group comprising patients matched by age, sex, and comorbidities but without inflammatory diseases of the cervix, vagina, or vulva.A total of 79,512 patients were included in the inflammatory disease group and an equal number of control individuals were selected. The incidence of endometriosis (hazard ratio, 2.01; 95% confidence interval, 1.91-2.12; P < 0.001) was higher among patients than controls. Cox proportional hazards models showed that irrespective of comorbidities, lower genital tract infection was an independent risk factor for endometriosis.Patients with lower genital tract infections exhibit a substantially higher risk for developing endometriosis. PMID:26962775

  19. C. elegans dopaminergic D2-like receptors delimit recurrent cholinergic-mediated motor programs during a goal-oriented behavior.

    PubMed

    Correa, Paola; LeBoeuf, Brigitte; García, L René

    2012-01-01

    Caenorhabditis elegans male copulation requires coordinated temporal-spatial execution of different motor outputs. During mating, a cloacal circuit consisting of cholinergic sensory-motor neurons and sex muscles maintains the male's position and executes copulatory spicule thrusts at his mate's vulva. However, distinct signaling mechanisms that delimit these behaviors to their proper context are unclear. We found that dopamine (DA) signaling directs copulatory spicule insertion attempts to the hermaphrodite vulva by dampening spurious stimulus-independent sex muscle contractions. From pharmacology and genetic analyses, DA antagonizes stimulatory ACh signaling via the D2-like receptors, DOP-2 and DOP-3, and Gα(o/i) proteins, GOA-1 and GPA-7. Calcium imaging and optogenetics suggest that heightened DA-expressing ray neuron activities coincide with the cholinergic cloacal ganglia function during spicule insertion attempts. D2-like receptor signaling also attenuates the excitability of additional mating circuits to reduce the duration of mating attempts with unproductive and/or inappropriate partners. This suggests that, during wild-type mating, simultaneous DA-ACh signaling modulates the activity threshold of repetitive motor programs, thus confining the behavior to the proper situational context. PMID:23166505

  20. New species of Spauligodon Skrjabin, Schikhobalova & Lagodovskaja, 1960 and Thubunea Seurat, 1914 (Nematoda) from the gastro-intestinal tract of lizards in Iran.

    PubMed

    Pazoki, Samaneh; Rahimian, Hassan

    2014-11-01

    As part of a faunistic study on helminth parasites of Iranian lizards collected from localities in the north of Isfahan province in Iran, two new nematode species belonging to two different families, Pharyngodonidae Travassos, 1919 and Physalopteroidae Railliet, 1893, were found and are, hereby, described. Spauligodon persiensis n. sp. from the large intestine of Cyrtopodion scabrum Heyden is characterised by its imperceptible lateral alae, lack of spicule, different shape of the genital curtain, position of last pair of papillae, aspinose tail in males, position of the vulva and excretory pore, and a tail filament with six to nine spines in females. Thubunea mobedii n. sp. from the stomach of Laudakia nupta nupta (De Filipi) differs from the other species in the genus by possessing a vulva at level of the posterior portion of the oesophageal-intestinal junction in females, lacking spicules, and having a different number of papillae in males. The present paper provides the results of detailed morphological examination of the two new nematode species, using both light and scanning electron microscopy. Taxonomically important characteristics for the members of the two nematode genera, Spauligodon Skrjabin, Schikhobalova & Lagodovskaja, 1960 and Thubunea Seurat, 1914, are also reviewed. PMID:25301515

  1. Subunit Principle of Vulvar Reconstruction: Algorithm and Outcomes

    PubMed Central

    Kang, Gavin Chun-Wui; Tay, Eng Hseon; Por, Yong Chen

    2014-01-01

    Background Vulvar defects result chiefly from oncologic resection of vulvar tumors. Reconstruction of vulvar defects restores form and function for the purpose of coitus, micturition, and defecation. Many surgical options exist for vulvar reconstruction. The purpose of this article is to present our experience with vulvar reconstruction. Methods From 2007 to 2013, 43 women presented to us with vulvar defects for reconstruction. Their mean age at the time of reconstruction was 61.1 years. The most common cause of vulvar defect was from resection of vulvar carcinoma and extramammary Paget's disease of the vulva. Method s of reconstruction ranged from primary closure to skin grafting to the use of pedicled flaps. Results The main complications were that of long term hypertrophic and/or unaesthetic scarring of the donor site in 4 patients. Twenty-two patients (51%) were able to resume sexual intercourse. There were no complications of flap loss, wound dehiscence, and urethral stenosis. Conclusions We present a subunit algorithmic approach to vulvar reconstruction based on defect location within the vulva, dimension of the defect, and patient age and comorbidity. The gracilis and gluteal fold flaps are particularly versatile and aesthetically suited for reconstruction of a variety of vulvar defects. From an aesthetic viewpoint the gluteal fold flap was superior because of the well-concealed donor scar. We advocate the routine use of these 2 flaps for vulvar reconstruction. PMID:25075361

  2. Imaging of the female perineum in adults.

    PubMed

    Hosseinzadeh, Keyanoosh; Heller, Matthew T; Houshmand, Golbahar

    2012-01-01

    The female perineum is a diamond-shaped structure inferior to the pelvic diaphragm and between the symphysis pubis and coccyx. The perineum is divided into the anterior urogenital triangle and the posterior anal triangle; the vulva represents the external genitalia. A wide array of diseases affect the female perineum in adults. Vulvar trauma, infection (including Fournier gangrene), developmental lesions, and thrombophlebitis can be investigated with various imaging modalities; vulvar malignancies are best imaged with magnetic resonance (MR) imaging to identify local-regional extent of disease. MR imaging is also the modality of choice for imaging of the distal urethra, although imaging of a urethral diverticulum also includes voiding cystourethrography and ultrasonography. The distal vagina at the level of the introitus is best imaged with MR imaging for assessment of Bartholin gland cysts and malignancies. Diseases encountered in the anus include anal carcinoma, fistula-in-ano, and anovaginal fistula, which can all be imaged with various modalities offering different sensitivities and fields of view. Lastly, musculoskeletal neoplasms affecting the perineum and vulva include mesenchymal, lipomatous, nerve sheath, and osseous neoplasms. These neoplasms can be imaged with both computed tomography and MR imaging, although the latter provides higher soft-tissue contrast and greater anatomic detail for diagnosis and determination of the extent of necessary surgery. Familiarity with the anatomy of the female perineum and appropriate selection of imaging modalities facilitate prompt and accurate diagnosis and treatment. PMID:22787005

  3. Intraspecific evolution of the intercellular signaling network underlying a robust developmental system

    PubMed Central

    Milloz, Josselin; Duveau, Fabien; Nuez, Isabelle; Félix, Marie-Anne

    2008-01-01

    Many biological systems produce an invariant output when faced with stochastic or environmental variation. This robustness of system output to variation affecting the underlying process may allow for “cryptic” genetic evolution within the system without change in output. We studied variation of cell fate patterning of Caenorhabditis elegans vulva precursors, a developmental system that relies on a simple intercellular signaling network and yields an invariant output of cell fates and lineages among C. elegans wild isolates. We first investigated the system’s genetic variation in C. elegans by means of genetic tools and cell ablation to break down its buffering mechanisms. We uncovered distinct architectures of quantitative variation along the Ras signaling cascade, including compensatory variation, and differences in cell sensitivity to induction along the anteroposterior axis. In the unperturbed system, we further found variation between isolates in spatio-temporal dynamics of Ras pathway activity, which can explain the phenotypic differences revealed upon perturbation. Finally, the variation mostly affects the signaling pathways in a tissue-specific manner. We thus demonstrate and characterize microevolution of a developmental signaling network. In addition, our results suggest that the vulva genetic screens would have yielded a different mutation spectrum, especially for Wnt pathway mutations, had they been performed in another C. elegans genetic background. PMID:18981482

  4. Changes in Men's Salivary Testosterone and Cortisol Levels, and in Sexual Desire after Smelling Female Axillary and Vulvar Scents.

    PubMed

    Cerda-Molina, Ana Lilia; Hernández-López, Leonor; de la O, Claudio E; Chavira-Ramírez, Roberto; Mondragón-Ceballos, Ricardo

    2013-01-01

    Several studies have shown that a woman's vaginal or axillary odors convey information on her attractivity. Yet, whether such scents induce psychoneuroendocrinological changes in perceivers is still controversial. We studied if smelling axillary and vulvar odors collected in the periovulatory and late luteal phases of young women modify salivary testosterone and cortisol levels, as well as sexual desire in men. Forty-five women and 115 men, all of them college students and unacquainted with each other, participated in the study. Female odors were collected on pads affixed to the axilla and on panty protectors both worn the entire night before experiments. Men provided five saliva samples, a basal one before the smelling procedure, and four more 15, 30, 60, and 75 min after exposure to odors. Immediately after smelling the odor source, men answered a questionnaire rating hedonic qualities of scents, and after providing the last saliva sample they answered questionnaire on sexual desire. We found that periovulatory axillary and vulvar odors increased testosterone and cortisol levels, with vulvar scents producing a more prolonged effect. Luteal axilla odors decreased testosterone and cortisol levels, while luteal vulva odors increased cortisol. Periovulatory axilla and vulva scents accounted for a general increase of interest in sex. These odors were also rated as more pleasant and familiar, while luteal vulvar odors were perceived as intense and unpleasant. PMID:24194730

  5. Changes in Men’s Salivary Testosterone and Cortisol Levels, and in Sexual Desire after Smelling Female Axillary and Vulvar Scents

    PubMed Central

    Cerda-Molina, Ana Lilia; Hernández-López, Leonor; de la O, Claudio E.; Chavira-Ramírez, Roberto; Mondragón-Ceballos, Ricardo

    2013-01-01

    Several studies have shown that a woman’s vaginal or axillary odors convey information on her attractivity. Yet, whether such scents induce psychoneuroendocrinological changes in perceivers is still controversial. We studied if smelling axillary and vulvar odors collected in the periovulatory and late luteal phases of young women modify salivary testosterone and cortisol levels, as well as sexual desire in men. Forty-five women and 115 men, all of them college students and unacquainted with each other, participated in the study. Female odors were collected on pads affixed to the axilla and on panty protectors both worn the entire night before experiments. Men provided five saliva samples, a basal one before the smelling procedure, and four more 15, 30, 60, and 75 min after exposure to odors. Immediately after smelling the odor source, men answered a questionnaire rating hedonic qualities of scents, and after providing the last saliva sample they answered questionnaire on sexual desire. We found that periovulatory axillary and vulvar odors increased testosterone and cortisol levels, with vulvar scents producing a more prolonged effect. Luteal axilla odors decreased testosterone and cortisol levels, while luteal vulva odors increased cortisol. Periovulatory axilla and vulva scents accounted for a general increase of interest in sex. These odors were also rated as more pleasant and familiar, while luteal vulvar odors were perceived as intense and unpleasant. PMID:24194730

  6. Occurrence of Leishmania infantum and associated histological alterations in the genital tract and mammary glands of naturally infected dogs.

    PubMed

    Boechat, Viviane Cardoso; Mendes Junior, Artur Augusto Velho; Madeira, Maria de Fátima; Ferreira, Luiz Claudio; Figueiredo, Fabiano Borges; Rodrigues, Francisco das Chagas de Carvalho; Oliveira, Valéria da Costa; de Oliveira, Raquel de Vasconcellos Carvalhaes; Menezes, Rodrigo Caldas

    2016-06-01

    The objectives of this study were to evaluate the occurrence of Leishmania infantum in the male and female genital tract and female mammary glands of dogs and the parasite burden and to identify histological alterations associated with this protozoan. Twenty male and 20 female Leishmania-seropositive dogs with isolation of L. infantum were examined. Tissue samples of the prepuce, glans, epididymis, testes, prostate, vulva, vagina, uterus, uterine tubes, and mammary glands were analyzed by immunohistochemistry and histopathology. For parasitological culture and in situ hybridization, samples were collected from the testis, epididymis, and uterus. Additionally, seminal fluid was aspirated from the epididymis for parasitological culture. In the genital tract, 34 (85 %) dogs, including 18 males and 16 females, were positive for Leishmania. Of these, 27 (79 %) animals were symptomatic. Leishmania was detected in the mammary glands of 13 (65 %) females. L. infantum was isolated for the first time from the seminal fluid and uterus of naturally infected dogs. The parasite burden and intensity of the inflammatory reaction were greater in the prepuce and glans of males and in the vulva and mammary glands of females. In addition to inflammation, testicular degeneration, atrophy, absence of spermatogenesis, and necrosis were observed. Detection of amastigote forms in the mammary gland lumen indicates possible elimination of this parasite in milk. The frequent parasitism observed in the genital tract of infected males and females and the viability of L. infantum in seminal fluid and uterus suggest the possibility of bidirectional venereal and vertical transmission. PMID:26979730

  7. Methods of estrus detection and correlates of the reproductive cycle in the sun bear (Helarctos malayanus).

    PubMed

    Frederick, Cheryl; Kyes, Randall; Hunt, Kathleen; Collins, Darin; Durrant, Barbara; Wasser, Samuel K

    2010-10-15

    The objective was to explore multiple methods for detecting and characterizing the reproductive cycle of the sun bear (Helarctos malayanus). Thirteen H. m. euryspilus females, loaned from the Malaysian government to US zoos, were used. Fecal metabolite concentrations of estrogen and progesterone were compared to vaginal cytology, changes in genital appearance, and behavior (videotapes and zookeeper observations). Cytology and video behavior were characterized during five hormonally defined states: high, low, and baseline progesterone, estrus, and high estrogen. Among states, there were significant differences in cytology and behavior. Sexual, affiliative, and stereotypic behaviors were highest during estrus, whereas affiliative and social behaviors were lowest during high progesterone. In this captive breeding population, 30.8% of females cycled two or three times a year, 30.8% cycled once a year, and 38.5% did not cycle during this study. Inter-estrus intervals were (mean ± SEM) 115.7 ± 6.3 d (range, 101-131). Spearman rank correlations were significant between both ordinal sexual and affiliative behaviors and vulva swelling and color. Sexual behavior was significantly positively correlated with superficial and keratinized cells, but negatively correlated with parabasal and basophilic cells in cycling females (opposite pattern for appetitive behavior). In conclusion, data for cytology, vulva changes and behavior were consistent with, and complementary to, hormonal data; collectively, they delineated estrus and identified specific reproductive types. PMID:20688366

  8. Epithelial vulvar neoplasms and their changing classification.

    PubMed

    Ball, Russell; Ball, Katherine M; Reutter, Jason

    2015-12-01

    In recent years, there have been many changes in the classification scheme for squamous lesions of the vulva; this is primarily due to the assimilation of new scientific information into the diagnostic terminology. For example, over the past 75 years we have realized that precancerous and cancerous lesions of the vulva may be induced by a variety of preconditions, which are typically divided into human papillomavirus (HPV) and non-HPV precursor lesions. The latter include several dermatoses, especially lichen sclerosus and lichen planus. Additionally, we have learned that HPV on extramucosal and nongenital sites does not have the same malignant potential as on mucosal or genital sites. Because of the frequent changes in nomenclature due to these discoveries, both old and new terms continue to be used in clinical practice; a summary of these terms is provided to help prevent a misunderstanding of their scope and significance. Important points for clinicians and pathologists who are involved in the care of these patients are provided. PMID:26650699

  9. C. elegans Dopaminergic D2-Like Receptors Delimit Recurrent Cholinergic-Mediated Motor Programs during a Goal-Oriented Behavior

    PubMed Central

    Correa, Paola; LeBoeuf, Brigitte; García, L. René

    2012-01-01

    Caenorhabditis elegans male copulation requires coordinated temporal-spatial execution of different motor outputs. During mating, a cloacal circuit consisting of cholinergic sensory-motor neurons and sex muscles maintains the male's position and executes copulatory spicule thrusts at his mate's vulva. However, distinct signaling mechanisms that delimit these behaviors to their proper context are unclear. We found that dopamine (DA) signaling directs copulatory spicule insertion attempts to the hermaphrodite vulva by dampening spurious stimulus-independent sex muscle contractions. From pharmacology and genetic analyses, DA antagonizes stimulatory ACh signaling via the D2-like receptors, DOP-2 and DOP-3, and Gαo/i proteins, GOA-1 and GPA-7. Calcium imaging and optogenetics suggest that heightened DA-expressing ray neuron activities coincide with the cholinergic cloacal ganglia function during spicule insertion attempts. D2-like receptor signaling also attenuates the excitability of additional mating circuits to reduce the duration of mating attempts with unproductive and/or inappropriate partners. This suggests that, during wild-type mating, simultaneous DA-ACh signaling modulates the activity threshold of repetitive motor programs, thus confining the behavior to the proper situational context. PMID:23166505

  10. Further Studies on Soil Nematode Fauna in North Western Iran with the Description of One New Species

    PubMed Central

    Pedram, Majid; Pourjam, Ebrahim; Atighi, Mohammad Reza; Panahandeh, Yousef

    2015-01-01

    Heterodorus youbertghostai n. sp. is described and illustrated based on morphological, morphometric, and molecular data. The new species was found in two geographically distant points in northwestern Iran and is characterized by having angular lip region, separated from the rest body by a constriction, body length of 1,432.5 to 1,751.3 µm, odontostyle length of 24 to 28 µm, rod-like odontophore, 37.0 to 42.5 µm long, lacking flanges at base, double guiding ring at 14 to 16 µm distance from anterior end, pharyngeal bulb comprising 40% to 48% of pharynx, intestine usually containing green material, female reproductive system amphidelphic with less divided short uterus, specific structure of pars distalis vaginae, bluntly conical tail, dorsally convex and ventrally flat, with rounded tip and saccate bodies in ventral side. The new species comes more close to H. conicaudatus and H. irregularis by its morphology and morphometric characters. Compared to former, it has remarkable difference in vulva position and tail characters, and compared to the latter, it could be separated by shorter body, posteriorly located vulva, wider lip region, and longer tail. In phylogenetic analyses using partial sequences of 28S rDNA D2-D3, the new species formed a fully supported clade with several isolates of H. brevidentatus, prevalent in Iran. The other nordiid taxon, Enchodorus dolichurus, already reported from Iran, was also sequenced for the same genomic region and included in phylogenetic analyses. PMID:26170477

  11. Further Studies on Soil Nematode Fauna in North Western Iran with the Description of One New Species.

    PubMed

    Pedram, Majid; Pourjam, Ebrahim; Atighi, Mohammad Reza; Panahandeh, Yousef

    2015-06-01

    Heterodorus youbertghostai n. sp. is described and illustrated based on morphological, morphometric, and molecular data. The new species was found in two geographically distant points in northwestern Iran and is characterized by having angular lip region, separated from the rest body by a constriction, body length of 1,432.5 to 1,751.3 µm, odontostyle length of 24 to 28 µm, rod-like odontophore, 37.0 to 42.5 µm long, lacking flanges at base, double guiding ring at 14 to 16 µm distance from anterior end, pharyngeal bulb comprising 40% to 48% of pharynx, intestine usually containing green material, female reproductive system amphidelphic with less divided short uterus, specific structure of pars distalis vaginae, bluntly conical tail, dorsally convex and ventrally flat, with rounded tip and saccate bodies in ventral side. The new species comes more close to H. conicaudatus and H. irregularis by its morphology and morphometric characters. Compared to former, it has remarkable difference in vulva position and tail characters, and compared to the latter, it could be separated by shorter body, posteriorly located vulva, wider lip region, and longer tail. In phylogenetic analyses using partial sequences of 28S rDNA D2-D3, the new species formed a fully supported clade with several isolates of H. brevidentatus, prevalent in Iran. The other nordiid taxon, Enchodorus dolichurus, already reported from Iran, was also sequenced for the same genomic region and included in phylogenetic analyses. PMID:26170477

  12. Application of the E-screen assay to test for oestrogenically active substances in swine feed.

    PubMed

    Bitsch, N; Körner, W; Postupka, S; Brunn, H

    2001-12-01

    A pig breeder in central Hesse (Germany) noticed the occurrence of enlarged vulvae in female piglets. Intoxication with oestrogenically active substances by contamination of two feed mixes ingested by the mother sows appeared to be a possible cause. Using a combined technique of the DFG analytical method S19 and the E-screen assay, two feed samples were found to contain powerful oestrogenically active compounds. By co-incubation with the anti-oestrogen tamoxifen it could be clearly demonstrated that the oestrogenic activity was mediated by the oestrogen receptor. These results demonstrate that use of the E-screen assay in combination with the DFG analytical method S19 provides a simple and readily usable prescreening method for the routine detection of oestrogenically active compounds in animal feed. The results from the E-screen assay show that the sows ingested 10-80 microg oestradiol equivalents per day in their feed. Because of the bioavailability of these substances, the oestrogenic active compounds seem to be transferred into the milk and passed to the piglets via suckling. The milk of the dam appears to contain this substance in biologically active form and at such high concentrations that the female piglets had enlarged vulvae. PMID:11906561

  13. A novel vaccine for cervical cancer: quadrivalent human papillomavirus (types 6, 11, 16 and 18) recombinant vaccine (Gardasil).

    PubMed

    Govan, Vandana A

    2008-02-01

    Human papillomaviruses (HPVs) are one of the most common sexually transmitted infections and remains a public health problem worldwide. There is strong evidence that HPV causes cervical, vulva and vaginal cancers, genital warts and recurrent respiratory papillomatosis. The current treatments for HPV-induced infections are ineffective and recurrence is common-place. Therefore, to reduce the burden of HPV-induced infections, several studies have investigated the effi cacy of different prophylactic vaccines in clinical human trials directed against HPV types 6, 11, 16, or 18. Notably, these HPV types contribute to a signifi cant proportion of disease worldwide. This review will focus on the published results of Merck & Co's prophylactic quadrivalent recombinant vaccine targeting HPV types 6, 11, 16, and 18 (referred to as Gardasil((R))). Data from the Phase III trial demonstrated that Gardasil was 100% effi cacious in preventing precancerous lesions of the cervix, vulva, and vagina and effective against genital warts. Due to the success of these human clinical trials, the FDA approved the registration of Gardasil on the 8 June 2006. In addition, since Gardasil has been effi cacious for 5 years post vaccination, the longest evaluation of an HPV vaccine, it is expected to reduce the incidence of these type specifi c HPV-induced diseases in the future. PMID:18728721

  14. Caution for Diagnosis and Surgical Treatment of Recurrent Cholangitis

    PubMed Central

    Wu, Zheng; Guo, Kun; Sun, Hao; Yu, Liang; Lv, Yi; Wang, Bo

    2014-01-01

    Abstract The hepatocellular carcinoma (HCC) patients with bile duct tumor thrombus (BDTT) usually have no specific clinical symptoms at early stages. HCC with BDTT was usually misdiagnosed when the intrahepatic tumor was small, even undetectable. In this study, 5 cases of HCC with BDTT misdiagnosed as choledocholithiasis and cholangitis in the local hospital are described. We analyzed retrospectively and summarized our experiences of these 5 HCC patients with BDTT misdiagnosed in the local hospital during the past 5 years. The diagnosis, treatment, and outcome of the patients are discussed. Three patients underwent hepatectomy with thrombectomy and T-tube drainage. One patient underwent hepatectomy with the resection of the common bile duct and hepatojejunostomy, and palliative surgery was performed in 1 patient with portal vein tumor thrombus and intrahepatic metastasis. The patients were followed for 6–22 months; 4 patients died of tumor recurrence and metastasis or hepatic failure, despite 3 of these patients having received transhepatic arterial chemotherapy and embolization or radiofrequency ablation therapy. Early and accurate diagnosis of HCC with BDTT is very important. When patients have a history of abnormal recurrent cholangitis, HCC with BDTT should be highly suspected. Intraductal ultrasonography (US), intraoperative US, and histopathological examination are very valuable for the diagnosis. The prognosis of HCC patients with BDTT is dismal. Identification of this type of patient is clinically important, because surgical treatment may be beneficial. PMID:25192487

  15. Effect of temperature on fatty acid composition in each lipid fraction of Spirometra erinaceieuropaei plerocercoids.

    PubMed

    Fukushima, T; Gao, T; Isobe, A; Hojo, N; Shiwaku, K; Yamane, Y

    2000-02-01

    The effects of temperature and host fatty acids on the fatty acid contents of Spirometra erinaceieuropaei plerocercoids were investigated to clarify their role in sparganosis. After 24 hr incubation at 18 C in host snake serum, omega6 series fatty acids, especially arachidonic acid in the phospholipid fraction of the plerocercoids, increased compared with those of plerocercoids incubated at 37 C. The changes in the ratio of polyunsaturated to saturated fatty acids in the phospholipid fraction of plerocercoids incubated in physiological saline for 6 hr at 10 C were almost the same as the changes at 37 C. The ratio of polyunsaturated to saturated fatty acids of the triglyceride fraction showed almost opposite change versus the phospholipid fraction. The percentage of arachidonic acid in the phospholipid fraction of plerocercoids increased during the first 3 hr of incubation and then decreased, regardless of temperature. At 37 C, the percentage of arachidonic acid in the free fatty acid fraction fell for the first 3 hr of incubation and was significantly elevated at the end of the 6-hr incubation. At 10 C, however, arachidonic acid in the free fatty acid fraction decreased for the first hour of incubation, increased at 3 hr of incubation, then decreased again. These results suggest that fatty acids of the plerocercoids are frequently exchanged between fractions. Plerocercoids can mobilize arachidonic acid to the free fatty acid fraction more quickly at lower temperature than at higher temperature. They may utilize mobilized arachidonic acid early in the infection stage to produce prostaglandins. Alternatively, they can incorporate arachidonic acid into the phospholipid fraction again when arachidonic acid is readily available in the environment. PMID:10701556

  16. Genetic Identification of Spirometra decipiens Plerocercoids in Terrestrial Snakes from Korea and China

    PubMed Central

    Jeon, Hyeong-Kyu; Park, Hansol; Lee, Dongmin; Choe, Seongjun; Kim, Kyu-Heon; Sohn, Woon-Mok; Eom, Keeseon S.

    2016-01-01

    Human sparganosis is a zoonotic disease caused by infection with larval forms (procercoid/plerocercoid) of Spirometra spp. The purpose of this study was to identify Spirometra spp. of infected snakes using a multiplex PCR assay and phylogenetic analysis of mitochondrial DNA sequence data from the spargana of terrestrial snakes obtained from Korea and China. A total of 283 snakes were obtained that included 4 species of Colubridae comprising Rhabdophis tigrinus tigrinus (n=150), Dinodon rufozonatum rufozonatum (n=64), Elaphe davidi (n=2), and Elaphe schrenkii (n=7), and 1 species of Viperidae, Agkistrodon saxatilis (n=60). The snakes were collected from the provinces of Chungbuk, Chungnam, and Gyeongbuk in Korea (n=161), and from China (n=122). The overall infection rate with spargana was 83% (235/283). The highest was recorded for D. rufozonatum rufozonatum (100%), followed by A. saxatilis (85%) and R. tigrinus tigrinus (80%), with a negative result for E. davidi (0%) and E. schrenkii (0%). The sequence identities between the spargana from snakes (n=50) and Spirometra erinaceieuropaei (KJ599680) or S. decipiens (KJ599679) control specimens were 90.8% and 99.2%, respectively. Pairwise genetic distances between spargana (n=50) and S. decipiens ranged from 0.0080 to 0.0107, while those between spargana and S. erinaceieuropaei ranged from 0.1070 to 0.1096. In this study, all of the 904 spargana analyzed were identified as S. decipiens either by a multiplex PCR assay (n=854) or mitochondrial cox1 sequence analysis (n=50). PMID:27180576

  17. The Burden of Parasitic Zoonoses in Nepal: A Systematic Review

    PubMed Central

    Devleesschauwer, Brecht; Ale, Anita; Torgerson, Paul; Praet, Nicolas; Maertens de Noordhout, Charline; Pandey, Basu Dev; Pun, Sher Bahadur; Lake, Rob; Vercruysse, Jozef; Joshi, Durga Datt; Havelaar, Arie H.; Duchateau, Luc; Dorny, Pierre; Speybroeck, Niko

    2014-01-01

    Background Parasitic zoonoses (PZs) pose a significant but often neglected threat to public health, especially in developing countries. In order to obtain a better understanding of their health impact, summary measures of population health may be calculated, such as the Disability-Adjusted Life Year (DALY). However, the data required to calculate such measures are often not readily available for these diseases, which may lead to a vicious circle of under-recognition and under-funding. Methodology We examined the burden of PZs in Nepal through a systematic review of online and offline data sources. PZs were classified qualitatively according to endemicity, and where possible a quantitative burden assessment was conducted in terms of the annual number of incident cases, deaths and DALYs. Principal Findings Between 2000 and 2012, the highest annual burden was imposed by neurocysticercosis and congenital toxoplasmosis (14,268 DALYs [95% Credibility Interval (CrI): 5450–27,694] and 9255 DALYs [95% CrI: 6135–13,292], respectively), followed by cystic echinococcosis (251 DALYs [95% CrI: 105–458]). Nepal is probably endemic for trichinellosis, toxocarosis, diphyllobothriosis, foodborne trematodosis, taeniosis, and zoonotic intestinal helminthic and protozoal infections, but insufficient data were available to quantify their health impact. Sporadic cases of alveolar echinococcosis, angiostrongylosis, capillariosis, dirofilariosis, gnathostomosis, sparganosis and cutaneous leishmaniosis may occur. Conclusions/Significance In settings with limited surveillance capacity, it is possible to quantify the health impact of PZs and other neglected diseases, thereby interrupting the vicious circle of neglect. In Nepal, we found that several PZs are endemic and are imposing a significant burden to public health, higher than that of malaria, and comparable to that of HIV/AIDS. However, several critical data gaps remain. Enhanced surveillance for the endemic PZs identified in this study would enable additional burden estimates, and a more complete picture of the impact of these diseases. PMID:24392178

  18. Human Infections with Spirometra decipiens Plerocercoids Identified by Morphologic and Genetic Analyses in Korea.

    PubMed

    Jeon, Hyeong-Kyu; Park, Hansol; Lee, Dongmin; Choe, Seongjun; Kim, Kyu-Heon; Huh, Sun; Sohn, Woon-Mok; Chai, Jong-Yil; Eom, Keeseon S

    2015-06-01

    Tapeworms of the genus Spirometra are pseudophyllidean cestodes endemic in Korea. At present, it is unclear which Spirometra species are responsible for causing human infections, and little information is available on the epidemiological profiles of Spirometra species infecting humans in Korea. Between 1979 and 2009, a total of 50 spargana from human patients and 2 adult specimens obtained from experimentally infected carnivorous animals were analyzed according to genetic and taxonomic criteria and classified as Spirometra erinaceieuropaei or Spirometra decipiens depending on the morphology. Morphologically, S. erinaceieuropaei and S. decipiens are different in that the spirally coiled uterus in S. erinaceieuropaei has 5-7 complete coils, while in S. decipiens it has only 4.5 coils. In addition, there is a 9.3% (146/1,566) sequence different between S. erinaceieuropaei and S. decipiens in the cox1 gene. Partial cox1 sequences (390 bp) from 35 Korean isolates showed 99.4% (388/390) similarity with the reference sequence of S. erinaceieuropaei from Korea (G1724; GenBank KJ599680) and an additional 15 Korean isolates revealed 99.2% (387/390) similarity with the reference sequences of S. decipiens from Korea (G1657; GenBank KJ599679). Based on morphologic and molecular databases, the estimated population ratio of S. erinaceieuropaei to S. decipiens was 35: 15. Our results indicate that both S. erinaceieuropaei and S. decipiens found in Korea infect humans, with S. erinaceieuropaei being 2 times more prevalent than S. decipiens. This study is the first to report human sparganosis caused by S. decipiens in humans in Korea. PMID:26174823

  19. Human Infections with Spirometra decipiens Plerocercoids Identified by Morphologic and Genetic Analyses in Korea

    PubMed Central

    Jeon, Hyeong-Kyu; Park, Hansol; Lee, Dongmin; Choe, Seongjun; Kim, Kyu-Heon; Huh, Sun; Sohn, Woon-Mok; Chai, Jong-Yil; Eom, Keeseon S.

    2015-01-01

    Tapeworms of the genus Spirometra are pseudophyllidean cestodes endemic in Korea. At present, it is unclear which Spirometra species are responsible for causing human infections, and little information is available on the epidemiological profiles of Spirometra species infecting humans in Korea. Between 1979 and 2009, a total of 50 spargana from human patients and 2 adult specimens obtained from experimentally infected carnivorous animals were analyzed according to genetic and taxonomic criteria and classified as Spirometra erinaceieuropaei or Spirometra decipiens depending on the morphology. Morphologically, S. erinaceieuropaei and S. decipiens are different in that the spirally coiled uterus in S. erinaceieuropaei has 5-7 complete coils, while in S. decipiens it has only 4.5 coils. In addition, there is a 9.3% (146/1,566) sequence different between S. erinaceieuropaei and S. decipiens in the cox1 gene. Partial cox1 sequences (390 bp) from 35 Korean isolates showed 99.4% (388/390) similarity with the reference sequence of S. erinaceieuropaei from Korea (G1724; GenBank KJ599680) and an additional 15 Korean isolates revealed 99.2% (387/390) similarity with the reference sequences of S. decipiens from Korea (G1657; GenBank KJ599679). Based on morphologic and molecular databases, the estimated population ratio of S. erinaceieuropaei to S. decipiens was 35: 15. Our results indicate that both S. erinaceieuropaei and S. decipiens found in Korea infect humans, with S. erinaceieuropaei being 2 times more prevalent than S. decipiens. This study is the first to report human sparganosis caused by S. decipiens in humans in Korea. PMID:26174823

  20. Genetic Structure Analysis of Spirometra erinaceieuropaei Isolates from Central and Southern China

    PubMed Central

    Zhang, Xi; Cui, Jing; Liu, Li Na; Jiang, Peng; Wang, Han; Qi, Xin; Wu, Xing Qi; Wang, Zhong Quan

    2015-01-01

    Background Sparganosis caused by invasion of the plerocercoid larvae (spargana) of Spirometra erinaceieuropaei have increased in recent years in China. However, the population genetic structure regarding this parasite is still unclear. In this study, we used the sequences of two mitochondrial genes cytochrome b (cytb) and cytochrome c oxidase subunit I (cox1) to analyze genetic variation and phylogeographic structure of the S. erinaceieuropaei populations. Methodology/Principal Findings A total of 88 S. erinaceieuropaei isolates were collected from naturally infected frogs in 14 geographical locations of China. The complete cytb and cox1 genes of each sample was amplified and sequenced. Total 61 haplotypes were found in these 88 concatenated sequences. Each sampled population and the total population have high haplotype diversity (Hd), accompanied by very low nucleotide diversity (Pi). Phylogenetic analyses of haplotypes revealed two distinct clades (HeN+HuN+GZ-AS clade and GX+HN+GZ-GY clade) corresponding two sub-networks yielded by the median-joining network. Pairwise FST values supported great genetic differentiation between S. erinaceieuropaei populations. Both negative Fus FS value of neutrality tests and unimodal curve of mismatch distribution analyses supported demographic population expansion in the HeN+HuN+GZ-AS clade. The BEAST analysis showed that the divergence time between the two clades took place in the early Pleistocene (1.16 Myr), and by Bayesian skyline plot (BSP) an expansion occurred after about 0.3 Myr ago. Conclusions S. erinaceieuropaei from central and southern China has significant phylogeographic structure, and climatic oscillations during glacial periods in the Quaternary may affect the demography and diversification of this species. PMID:25793277

  1. [Parasitic zoonoses in Japan, with special reference to the current topics].

    PubMed

    Yoshimura, K

    1989-11-01

    The present situation of parasitic zoonoses in Japan is reviewed. A total of 51 species, i.e., 6 species of protozoan parasites, 14 species of trematode parasites, 11 species of cestode parasites, 18 species of nematode parasites and 2 species of acanthocephalan parasites are potential zoonotic parasites. Most (11 species) of the zoonotic nematodes provoke larva migrans. Habitats of zoonotic parasites vary greatly depending upon individual species. Some parasites cause heterotopic parasitism (e.g., Paragonimus westermani) and metastasis (Entamoeba histolytica). In larva migrans, parasites migrate through various parts of body tissues, affecting multiple organs (gnathostomiasis and sparganosis mansoni). The majority of parasitic zoonoses are food-borne infections. Some of them are an arthropod-borne (or -mediated) infection (dirofilariasis, thelaziasis and moniliformiasis), or acquired by percutaneous infection with cercariae (schistosome cercarial dermatitis) or 3rd-stage infective larvae (hookworm diseases). The diagnosis of parasitic zoonoses, especially larva migrans, is difficult; although some unique clinical symptoms and the presence of eosinophilia and/or increased level of serum IgE antibody are frequently seen in larva migrans, the application of various immunodiagnostic methods is usually required. For the prevention and control of parasitic zoonoses, the ingestion of not only strange food (e.g., snakes, frogs, slugs, etc.) but also raw fish and cuttlefish (sashimi) must be prohibited. Fishes and the meat of wild animals (e.g., bear and wild boar) should be frozen or thoroughly cooked before eating. Pets and domestic animals play an important role as a direct or indirect source of infection with various parasitic zoonoses. The treatment of those animals and/or the eradication of intermediate hosts (or vectors) of the parasites are thus required. PMID:2513435

  2. The urogenital system and the menopause.

    PubMed

    Calleja-Agius, J; Brincat, M P

    2015-10-01

    The major cause of urogenital atrophy in menopausal women is estrogen loss. The symptoms are usually progressive in nature and deteriorate with time from the menopausal transition. The most prevalent urogenital symptoms are vaginal dryness, vaginal irritation and itching. The genitourinary syndrome of menopause includes vulvovaginal atrophy and the postmenopausal modifications of the lower urinary tract. Dyspareunia and vaginal bleeding from fragile atrophic skin are common problems. Other urogenital complaints include frequency, nocturia, urgency, stress urinary incontinence and urinary tract infections. Atrophic changes of the vulva, vagina and lower urinary tract can have a large impact on the quality of life of the menopausal woman. However, hormonal and non-hormonal treatments can provide patients with the solution to regain the previous level of function. Therefore, clinicians should sensitively question and examine menopausal women, in order to correctly identify the pattern of changes in urogenital atrophy and manage them appropriately. PMID:26366796

  3. Treatment of the genitourinary syndrome of menopause.

    PubMed

    Palacios, S; Mejía, A; Neyro, J L

    2015-10-01

    The vagina, vulva, vestibule, labia majora/minora, and bladder trigone have a high concentration of estrogen receptors; therefore, they are a sensitive biological indicator of serum levels of these hormones in women. The estrogen loss in postmenopausal women produces a dysfunction called genitourinary syndrome of menopause. The principal therapeutic goal in the genitourinary syndrome of menopause is to relieve symptoms. Treatment options, as well as local and systemic hormonal treatment are changes in lifestyle and non-hormonal treatments mainly based on the use of moisturizers and lubricants. New treatments that have recently appeared are ospemifeme, the first selective hormone receptor modulator for dyspareunia and vulvovaginal atrophy treatment, and the use of vaginal laser. This review has been written with the intention of giving recommendations on the prevention and treatment of genitourinary syndrome of menopause. PMID:26366797

  4. Genitourinary syndrome of the menopause--dawn of a new era?

    PubMed

    Panay, N

    2015-10-01

    Many millions of postmenopausal women continue to suffer in silence from symptoms resulting from estrogen-deficient atrophy of the vulva, vagina and urinary tract whilst the medical profession continues to debate what the condition should be called, how it should be assessed and whether it should be universally treated. It is high time that a unified approach was adopted by all medical societies to reach a consensus on definitions, recognition and management. With the development of the nomenclature for genitourinary syndrome of the menopause (GSM), advances in GSM assessment tools and quality-of-life questionnaires and novel therapeutic interventions, the signs are positive that a new era is finally dawning. PMID:26366795

  5. Skin and wound infections: an overview.

    PubMed

    O'Dell, M L

    1998-05-15

    Skin infections are common and may be caused by bacteria, fungi or viruses. Breaks in the skin integrity, particularly those that inoculate pathogens into the dermis, frequently cause or exacerbate skin infections. Bacterial skin infections caused by corynebacteria include erythrasma, trichomycosis axillaris and pitted keratolysis. Staphylococci may cause impetigo, ecthyma and folliculitis. Streptococcal skin infections include impetigo and erysipelas. Human papillomavirus skin infections present as several different types of warts, depending on the surface infected and its relative moisture, and the patterns of pressure. The many dermatomycoses (skin infections caused by fungi or yeasts) include tinea capitis, tinea barbae, tinea cruris, tinea manus, tinea pedis and tinea unguium (onychomycosis). Candidal infections occur in moist areas, such as the vulva, mouth, penis, skinfolds and diaper area. Wounds caused by wood splinters or thorns may result in sporotrichosis. Animal bites may result in complex, serious infections, requiring tetanus and, possibly, rabies prophylaxis in addition to appropriate antibiotic therapy. PMID:9614412

  6. A new species of Syphacia (Nematoda: Oxyuridae) from Calomys laucha (Rodentia: Cricetidae) in an agroecosystem of central Argentina.

    PubMed

    Herrera, Elba Juliana Rojas; Miño, Mariela Haydée; Notarnicola, Juliana; Robles, María del Rosario

    2011-08-01

    A new oxyurid nematode Syphacia hodarae n. sp. is described from the cecum and rectum of the cricetid rodent Calomys laucha Fischer, 1814 (Sigmodontinae, Phyllotini), captured in an agroecosystem of central Argentina. The new species is distinguished from other members of the genus mainly by the shape of the cephalic plate, presence of cervical alae in females, absence of lateral alae, and absence of deirids. Some characters are shared with Syphacia carlitosi, a parasite of Akodon azarae from the wetlands in Argentina. However, S. hodarae can be differentiated from this species by the absence of ornamentation on the accessory hook of the gubernaculum, length of spicule and gubernaculum, size of the eggs, and distance to the vulva from the anterior end. This is the first record of a Syphacia species from the tribe Phyllotini in Argentina, and the first time a Syphacia species is reported from C. laucha . PMID:21506826

  7. [Cuniculatum carcinoma. 6 cases and review of the literature].

    PubMed

    Delahaye, J F; Janser, J C; Rodier, J F; Auge, B

    1994-02-01

    The cuniculatum carcinoma is a rare type of epidermoid carcinoma. We report 6 cases with different localizations ("oral cavity and larynx", vulva, lower limb) treated over a 23-year period. Diagnosis is particularly difficult and requires careful clinical examination completed by deep surgical biopsy for histology. The aetiology of the tumour is not well defined. It presents as a slow growing wart with local malignancy and chronic suppuration. Extension to lymph nodes is rare. Histologically there is proliferative deep malpighian infiltration with an aspect of normal cell maturation. Galeries are hollowed out giving the aspect of a rabbit burrow (cuniculatum). Surgery is the only treatment, generally without lymph node curage. Radiotherapy is contraindicated due to anaplastic transformation. PMID:8207099

  8. Litomosoides (Nemata: Filarioidea) of bats from Bolivia with records for three known species and the description of a new species.

    PubMed

    Notarnicola, Juliana; Ruíz, F Agustín Jiménez; Gardner, Scott L

    2010-08-01

    Herein, we describe Litomosoides salazari n. sp. collected from the body cavity of the yellow bat, Lasiurus ega , from Bolivia. This new species of filarioid nematode is most closely related to the carinii group and is characterized by its relatively small size with the vulva located slightly posterior to the esophago-intestinal junction; an arrow-shaped buccal capsule; and a short, rounded tail. New host and locality records for both Litomosoides hamletti and L. chandleri in phyllostomid bats, and L. brasiliensis occurring in both phyllostomid and vespertilionid bats, are provided. The morphological variability of the specimens is documented by providing comparative measurements of 3 known species. Litomosoides brasiliensis occurs in 6 species of bats from Bolivia and was the most common species of filarioid nematode encountered. All 4 species of nematodes, including the new species, were found in sympatry at Chijchijpa, a locality in the Yungas of Bolivia. PMID:20738202

  9. A Forward Genetic Screen for Suppressors of Somatic P Granules in Caenorhabditis elegans.

    PubMed

    Kelly, Ashley L; Senter-Zapata, Michael J; Campbell, Anne C; Lust, Hannah E; Theriault, Monique E; Andralojc, Karolina M; Updike, Dustin L

    2015-10-01

    In Caenorhabditis elegans, germline expression programs are actively repressed in somatic tissue by components of the synMuv (synthetic multi-vulva) B chromatin remodeling complex, which include homologs of tumor suppressors Retinoblastoma (Rb/LIN-35) and Malignant Brain Tumor (MBT/LIN-61). However, the full scope of pathways that suppress germline expression in the soma is unknown. To address this, we performed a mutagenesis and screened for somatic expression of GFP-tagged PGL-1, a core P-granule nucleating protein. Eight alleles were isolated from 4000 haploid genomes. Five of these alleles exhibit a synMuv phenotype, whereas the remaining three were identified as hypomorphic alleles of known synMuv B genes, lin-13 and dpl-1. These findings suggest that most suppressors of germline programs in the soma of C. elegans are either required for viability or function through synMuv B chromatin regulation. PMID:26100681

  10. A Forward Genetic Screen for Suppressors of Somatic P Granules in Caenorhabditis elegans

    PubMed Central

    Kelly, Ashley L.; Senter-Zapata, Michael J.; Campbell, Anne C.; Lust, Hannah E.; Theriault, Monique E.; Andralojc, Karolina M.; Updike, Dustin L.

    2015-01-01

    In Caenorhabditis elegans, germline expression programs are actively repressed in somatic tissue by components of the synMuv (synthetic multi-vulva) B chromatin remodeling complex, which include homologs of tumor suppressors Retinoblastoma (Rb/LIN-35) and Malignant Brain Tumor (MBT/LIN-61). However, the full scope of pathways that suppress germline expression in the soma is unknown. To address this, we performed a mutagenesis and screened for somatic expression of GFP-tagged PGL-1, a core P-granule nucleating protein. Eight alleles were isolated from 4000 haploid genomes. Five of these alleles exhibit a synMuv phenotype, whereas the remaining three were identified as hypomorphic alleles of known synMuv B genes, lin-13 and dpl-1. These findings suggest that most suppressors of germline programs in the soma of C. elegans are either required for viability or function through synMuv B chromatin regulation. PMID:26100681

  11. Late injury of cancer therapy on the female reproductive tract

    SciTech Connect

    Grigsby, P.W.; Russell, A.; Bruner, D.

    1995-03-30

    The purpose of this article is to review the late effects of cancer therapy on the female reproductive tract. The anatomic sites detailed are the vulva, vagina, cervix, uterus, fallopian tubes, and ovaries. The available pathophysiology is discussed. Clinical syndromes are presented. Tolerance doses of irradiation for late effects are rarely presented in the literature and are reviewed where available. Management strategies for surgical, radiotherapeutic, and chemotherapeutic late effects are discussed. Endpoints for evaluation of therapeutic late effects have been formulated utilizing the symptons, objective, management, and analytic (SOMA) format. Late effects on the female reproductive tract from cancer therapy should be recognized and managed appropriately. A grading system for these effects is presented. Endpoints for late effects and tolls for the evaluation need to be further developed. 61 refs., 9 figs., 13 tabs.

  12. Vaginal condylomata acuminata after McIndoe neovagina creation.

    PubMed

    Haney, A F

    1990-01-01

    The author encountered vaginal condylomata acuminata in two women after McIndoe neovagina creations. By in situ DNA hybridization, the authors identified human papillomavirus type 6 in both women. The large exophytic pattern of growth in the neovagina was more characteristic of that encountered on the natural keratinized squamous epithelium of the vulva and perianal area than of the micropapillary and small flat lesions usually found on natural vaginal mucosa. These observations suggest that (1) this is not a rare infection, considering the low frequency of McIndoe neovagina creations; (2) the development of genital warts is probably related to contact with the etiologic virus; and (3) the intrinsic nature of the infected epithelium, as well as the new "vaginal" environment, may help determine the gross characteristics of the lesions. Women with neovaginas should be encouraged to have their sex partners use condoms, despite the lack of a need for contraception. PMID:2163112

  13. [Chromolymphography in the oncological surgical clinic].

    PubMed

    Remizov, A L; Bokham, Ia V; Vasil'ev, B V; Stukov, A N; Tobilevich, V P

    1978-05-01

    A new Soviet preparation for colour lymphography--chromolymphotrast--is presented in this paper. Radiopaque lymphography with the use of chromolymphotrast was carried out upon more than 50 patients with carcinoma of the uterine cervix and of the body of the womb. Besides, there is information concerning a successful use of the chromolymphotrast in cases of cancer of the vulva, mammary gland and rectum. Colour lymphography with the use of chromolymphotrast contributes to a more complete removal of lymphatic collectors. After a preliminary lymphography surgical interventions have acquired a radical character in 93.6% of operations on lymphatic nodes, thus adding to a decrease of the incidence rate of regional recurrences. The national medical industry has proceeded to the production of the preparation, which builds up the conditions for a broad use of colour radiopaque lymphography in oncology. PMID:664167

  14. Photodynamic therapy in patients with recurrent gynecological carcinomas

    NASA Astrophysics Data System (ADS)

    Hetzel, Heinz; Mueller, Elisabeth; Kostron, Herwig

    1993-03-01

    Patients with recurrent gynecological carcinomas have a poor prognosis with a median survival time of 3 - 6 months. Four patients with recurrent vulva carcinomas, one patient with a recurrent breast cancer, and one with a recurrent cervical carcinoma underwent PDT after parenteral or topical sensitization with Photosan 3. Of those patients two women made a complete recovery with no evidence of disease 27 and 24 months after. One patient responded partially with two recurrences which were retreated twice after topical sensitization, she has survived 16 months. The remaining patients showed partial response and died 3 and 8 months after PDT. The energy delivered by an argon-dye-laser ranged between 225 and 750 J/cm2. Photosan 3 was given intravenously at a dose of 2.5 mg/kg body weight and was tolerated without any allergic reaction. A response rate of nearly 50% in recurrent gynecological malignancies encourages us to pursue PDT in gynecological diseases.

  15. Becker's Nevus Syndrome.

    PubMed

    Dasegowda, Sathyanarayana B; Basavaraj, Gb; Nischal, Kc; Swaroop, Mr; Umashankar, Np; Swamy, Suchetha S

    2014-07-01

    Becker's nevus is a cutaneous hamartoma characterized by circumscribed hyperpigmentation with hypertrichosis. Becker's nevus syndrome is an association of Becker's nevus with unilateral breast hypoplasia and muscle, skin, and/or skeletal abnormalities. We here report a case of a 15 year-old female who presented with bilateral Becker's nevus over her groins, thighs, vulva, and in front of the neck from the age of 5 years. She had associated mental retardation, delayed development of mile stones, delayed puberty, dwarfism, depressed nasal bridge, long slender digits, crowding of lateral toes, valgus deformity of first metatarsophalangeal joint, mitral valve prolapse, muddy conjunctiva with hypertrophic and hyperpigmented caruncle of both eyes, ichthyosis, brownish hair, and absence of axillary and pubic hair. On histopathological examination collagen hamartoma underneath the Becker's nevus was found. PMID:25071279

  16. Description of a New and Two Known Species of the Free-living Nematode Paroigolaimella Paramonov, 1952 (Diplogastridae) from India

    PubMed Central

    Tahseen, Qudsia; Ahlawat, Shikha; Mustaqim, Malka

    2015-01-01

    This paper describes a new and two known species of Paroigolaimella collected from India. Paroigolaimella helalii n. sp. is characterized by having conspicuous sexual dimorphism in the stoma and pharynx, ovaries with a sphincter separating the mature oocyte from developing ones, a vagina leading to a strong ovijector, a pore-like vulva with cuticular flap; males with slender strongly arcuate spicules with dilated capitula; the gubernaculum slender with expanded plate-like distal end and nine pairs of genital papillae, and four to five pairs of copulatory muscle bands. P. coprophila (Sudhaus and Rehfeld, 1990) Sudhaus and Fürst von Lieven, 2003 collected from leaf litter from a farmyard has been redescribed with reassessment of its distinguishing characters from P. bernensis. P. bodamica (Micoletzky, 1922) n. comb. has been described and its status has been discussed with context to P. bernensis. PMID:26941464

  17. Oscheius tipulae.

    PubMed Central

    Félix, Marie-Anne K

    2006-01-01

    Oscheius tipulae is a common soil nematode of the same family as C. elegans (Rhabditidae), which presents the same hermaphroditic mode of reproduction and is easily cultured in the same conditions. Oscheius tipulae has been used as a developmental genetic model system to study vulva formation. Compared to C. elegans, it has a simpler vulval cell lineage, a reduced competence group and a different mechanism of vulval cell fate patterning. The spectrum of vulval phenotypes obtained in genetic screens differs from that found in C. elegans. Its easy isolation from soil and the availability of numerous wild isolates of O. tipulae from all over the world facilitate population genetic and microevolutionary studies, especially of the evolution of cell lineage. The Oscheius genus also presents many species with interesting evolutionary changes in mode of reproduction, gonad development, body size, etc. PMID:18050438

  18. [Aggressive angiomyxoma of the female pelvis and perineum, M-8841/1].

    PubMed

    Husek, K; Zavadilová, H; Cernoch, J

    1991-03-01

    Aggressive angiomyxoma of pelvis and perineum was identified in two women (of 31 and 53). Its site was in the right fossa ischiorectalis and vulva. There was not observed any relaps in 60 and/or 9 months after surgery. Amorphous tumour mass was soft with finger-like projections. Spindle and starshaped tumour cells were spread in a loose edematous myxoid vascularized stroma; they had a benign character lacking of mitoses and nuclear atypia. Myxoid stroma could be stained rather faintly with Alcian blue at pH 1. Dilated capillaries, veins and arterioles were a substantial component of the tumour. Nerve and muscle fibres and their fragments were included here and there in the tumour. Tumour cells had a fibroblast ultrastructure which was supported by immunohistology. Discussion comprised differential diagnosis of myxoma, myxoid liposarcoma and myxoid type malignant fibrous histiocytoma among others. PMID:1893427

  19. [That was already known in old Rome--care of brood animals in antiquity].

    PubMed

    Schäffer, J

    1993-09-01

    The paper gives an impression of the care for mother animals in antiquity, particularly in the course of Roman livestock farming (Varro, Columella). Especially noninfectious factors were held responsible for the redemption of the interruption of pregnancy and a complicated parturition. Therefore special attention was paid for the right and optimal livestock, grooming and nutrition of the farm animals. In the case of dystocia, the herdsmen and veterinarians reached for correction of presentation, traction and embryotomy during parturition. However, the placental retention was only treated with drugs. In the case of an uterine prolapse, Apsyrtos recommended for the first time the reposition at the casted animal and the triple closure of the vulva. PMID:8216200

  20. Unusual presence of Ornidia robusta (Diptera: Syrphidae) causing pig myiasis in Argentina.

    PubMed

    López Millán, Cyntia; Olea, María S; Dantur Juri, María J

    2015-12-01

    Myiasis is caused by dipterous larvae from the Calliphoridae, Sarcophagidae, Muscidae, Cuterebridae, and Syrphidae families. In this work, Cochliomyia hominivorax, Chrysomya megacephala, and Ornidia robusta were identified causing vulva, ear, and leg myiasis in pigs in Tucuman province, northwestern Argentina. The report of the presence of C. hominivorax and C. megacephala is very important due to their role as myiasis-causing and disease vectors. The occurrence of Ornidia robusta is remarkable, since it constitutes the first record of myiasis in general and of myiasis in pigs in particular. Lastly, the presence of Sarcophaga spp. is also interesting, since some of them originate myiasis and are therefore of concern for cattle, wild animals, and human populations. PMID:26450595